S/S Assessment

Uncontrolled bleeding Reviewing history and evaluation of the

delivery for potential risk factors. Check
Decreased blood Pressure
for the size of uterus, a boggy uterus
Increased heart rate indicates poor uterine tone and should
be indicated as a red flag. Also, check
Swelling and pain in tissues around vagina for heavy clots or presence of heavy
and the perianal area due to hematoma bleeding. Assess the cervix lacerations
Decreased cell count. and check the uterine cavity for clots.

Causes
Complications
Hypovolemic shock
The major cause is the
Disseminated intravascular
coagulation. increased contractions of the
Postpartum hemorrhage

m
Liver failure.

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Excessive loss of blood from women blood vessels that the placenta

co
Acute Kidney Injury. especially after giving birth leading to

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loss of approximately 500mls of blood was attached before removal
Acute respiratory distress

o.
syndrome. after birth. Uterine atony results
rs e
ou urc
Death
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Treatment; Medication to stimulate uterine

aC s

contractions.
vi y re

Removal of placenta pieces that remain in the

uterus, manual massage of the uterus,
examination of uterus and other pelvic tissues
ed d

and tying off the blood vessels using uterine

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compression sutures.

Diagnosis: Estimation of the fluid volume to

is

Intervention: Blood transfusion that involves

gauge the level that correlates to the level of cross matching and blood typing to replace the
Th

excessive bleeding after birth. blood loss.

Detection of abnormalities in pulse rate and Administration of oxygen especially in case of
blood pressure measurement respiratory distress.
sh

Estimation of the hematocrit levels and the Administration of Pitocin to maintain the tone
clotting factors in blood. of the uterus.
Administration of carboprost tromethamine to
facilitate uterine contractions.

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 References
Abdul‐Kadir, R., McLintock, C., Ducloy, A. S., El‐Refaey, H., England, A., Federici, A. B., ... &

James, A. H. (2014). Evaluation and management of postpartum hemorrhage: consensus

from an international expert panel. Transfusion, 54(7), 1756-1768.

Ducloy-Bouthors, A. S., Susen, S., Wong, C. A., Butwick, A., Vallet, B., & Lockhart, E. (2014).

Medical advances in the treatment of postpartum hemorrhage. Anesthesia & Analgesia,

119(5), 1140-1147.
Kramer, M. S., Berg, C., Abenhaim, H., Dahhou, M., Rouleau, J., Mehrabadi, A., & Joseph, K. S.

(2013). Incidence, risk factors, and temporal trends in severe postpartum hemorrhage.

m
American Journal of Obstetrics & Gynecology, 209(5), 449-e1.

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co
eH w
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rs e
ou urc
o
aC s
vi y re
ed d
ar stu
is
Th
sh

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