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Management

Authoring team

  • prevented by syntometrine (NB beware an unborn twin) (comprises syntocinon - phasic contraction - and ergometrine - tonic contraction)
  • identify the at risk patients

In PPH: 1. Rubbing the uterus causes it to contract 2. Ergometrine, IV, 0.5 mgs 3. IV infusion of syntocinon 4. Blood: cross match, Hb levels and coagulation 5. Catheterise and monitor output 6. Monitor CVP 7. Bimanual squeezing of the uterus 8. Contracted uterus but still bleeding: EUA - vulva, vagina, cervix - check for laceration Examine placenta - ie checking for RPOC. 9. Persistent atony: IV prostaglandins (or myometrial) 10. Laparotomy: internal iliac artery ligation 11. Hysterectomy (last resort)

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