POSTPARTUM HEMORRHAGE

POSTPARTUM HEMORRHAGE- 500 ml or more blood loss, usually on the first hour after deliver

CAUSES:

• retained Placenta due to manual removal of placenta, placenta acreta
  
• Uterine Atony-the relaxation of uterus due to excessive amniotic fluid, prolonged labor, overdose of anesthesia, and multiple pregnancy
• Laceration of the vagina, cervix or perineum during forcept delivery, size incompatibility of infant and the birth canal

SIGNS AND SYMPTOMS:

• uterus relax- soft to palpate ang boggy
• excessive bleeding
• patient is pale and weak

NURSING CARES:

• monitor vital signs every 30 minutes or one hour
  
• observe the amount and type of bleeding or the lochia if present, blood clots
• alleviate anxiety of the the patient due to her bleeding or condition
• provide information about her condition
• assist family support
  
• regulate IV fluids correctly as ordered
• crossmatched blood must be available in case needed for blood transfusion
  
• keep patient nothing per oral so as always be ready for emergency procedure specially if bleeding can' stop
• maintain the room calm and quiet atmosphere
• always use sterile gloves or instrument when doing vaginal examination to prevent further infection
• perineal care aseptically
• encourage voiding

source: maternal books and my nursing notes