Postpartum
Haemorrhage
Description
▪ Postpartum haemorrhage is blood loss of more than
500 mL following the birth of a new born.
Aetiology
1. Early postpartum haemorrhage, which is usually due
to uterine atony, lacerations, or retained placental
fragments, occurs in the first 24 hours after delivery.
2. Late postpartum haemorrhage occurs after the first 24
hours after delivery and is generally caused by
retained placental fragments or bleeding disorders.
Pathophysiology
▪ Delayed uterine atony or placental fragments prevent
the uterus from contracting effectively. The uterus is
unable to form an effective clot structure and bleeding
ensues or continues.
Assessment Findings
, Common clinical manifestations include:
1. Vaginal bleeding is the obvious sign of postpartum
haemorrhage; amount and character vary with cause.
2. Signs of impending shock include changes in skin
temperature and colour, and altered level of
consciousness.
Nursing Management
1. Prevent excessive blood loss and resulting
complications.
a. Massage the uterus, facilitate voiding, and report
blood loss.
b. Monitor blood pressure and pulse rate every 5 to 15
minutes.
c. Prepare for intravenous infusion, oxytocin and blood
transfusion, if needed.
d. Administer medications and oxygen as prescribed. (
Drug Chart )
e. Measure and record fluid intake and output.
f. Be prepared for possible dilation and curettage (D&C).
2. Assist the client and family to deal with physical and
emotional stresses of postpartum complications.
Drug Chart Medications Used for Postpartum
Complications
Classifications Used for Selected Interventions
▪ Blocks the ▪ Heparin IV should
conversion of be administered as
prothrombin to a “piggy back”
thrombin and infusion.
fibrinogen to ▪ Heparin SQ is given
fibrin thus deep into the site
Anticoagulants decreasing (abdomen), sites are
Heparin sodium clotting ability rotated, do not
injection ▪ Inhibits aspirate, apply
(Healea) thrombus and pressure (do not
Love NOx clot formation massage).
Haemorrhage
Description
▪ Postpartum haemorrhage is blood loss of more than
500 mL following the birth of a new born.
Aetiology
1. Early postpartum haemorrhage, which is usually due
to uterine atony, lacerations, or retained placental
fragments, occurs in the first 24 hours after delivery.
2. Late postpartum haemorrhage occurs after the first 24
hours after delivery and is generally caused by
retained placental fragments or bleeding disorders.
Pathophysiology
▪ Delayed uterine atony or placental fragments prevent
the uterus from contracting effectively. The uterus is
unable to form an effective clot structure and bleeding
ensues or continues.
Assessment Findings
, Common clinical manifestations include:
1. Vaginal bleeding is the obvious sign of postpartum
haemorrhage; amount and character vary with cause.
2. Signs of impending shock include changes in skin
temperature and colour, and altered level of
consciousness.
Nursing Management
1. Prevent excessive blood loss and resulting
complications.
a. Massage the uterus, facilitate voiding, and report
blood loss.
b. Monitor blood pressure and pulse rate every 5 to 15
minutes.
c. Prepare for intravenous infusion, oxytocin and blood
transfusion, if needed.
d. Administer medications and oxygen as prescribed. (
Drug Chart )
e. Measure and record fluid intake and output.
f. Be prepared for possible dilation and curettage (D&C).
2. Assist the client and family to deal with physical and
emotional stresses of postpartum complications.
Drug Chart Medications Used for Postpartum
Complications
Classifications Used for Selected Interventions
▪ Blocks the ▪ Heparin IV should
conversion of be administered as
prothrombin to a “piggy back”
thrombin and infusion.
fibrinogen to ▪ Heparin SQ is given
fibrin thus deep into the site
Anticoagulants decreasing (abdomen), sites are
Heparin sodium clotting ability rotated, do not
injection ▪ Inhibits aspirate, apply
(Healea) thrombus and pressure (do not
Love NOx clot formation massage).
