Postpartum hemorrhage: Difference between revisions
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==Management== | ==Management== | ||
#Fluid resuscitation | #Fluid resuscitation | ||
#Consider Blood Products for Hemodynamic Instability | |||
#Treat underlying cause: | #Treat underlying cause: | ||
##Uterine atony: | ##Uterine atony: | ||
###Oxytocin 10mg IM or slow IV push (rapid administration may cause hypotension) | ###Bimanual Massage | ||
###Misoprostol 600mcg SL | ###Oxytocin (Pitocin) 10mg IM or slow IV push (rapid administration may cause hypotension) | ||
###Misoprostol (Cytotec) 600mcg SL | |||
###Methylergonovine (Methergine) 0.2mg IM (contraindicated in pts with HTN or Preeclampsia) | |||
###Carboprost (Hemabate) 250mcg IV (avoid in pts with HTN or asthma) | |||
##Uterine inversion: | ##Uterine inversion: | ||
###Manually replace placenta: | ###Manually replace placenta: | ||
Revision as of 05:59, 4 April 2012
Causes
- Uterine atony
- Retained placental fragments
- Lower genital tract lacerations
- Uterine rupture
- Uterine inversion
- Hereditary coagulopathy
Management
- Fluid resuscitation
- Consider Blood Products for Hemodynamic Instability
- Treat underlying cause:
- Uterine atony:
- Bimanual Massage
- Oxytocin (Pitocin) 10mg IM or slow IV push (rapid administration may cause hypotension)
- Misoprostol (Cytotec) 600mcg SL
- Methylergonovine (Methergine) 0.2mg IM (contraindicated in pts with HTN or Preeclampsia)
- Carboprost (Hemabate) 250mcg IV (avoid in pts with HTN or asthma)
- Uterine inversion:
- Manually replace placenta:
- Place hand inside the vagina and push the fundus cephalad along long axis of vagina
- Manually replace placenta:
- Uterine atony:
See Also
Source
Tintinalli