Principles of management of postpartum hemorrhage

We all know that the process of childbirth is particularly dangerous. Some women choose cesarean section to reduce the risk of childbirth. Some women choose natural childbirth to strengthen the immunity of the fetus in the future. However, women who give birth naturally are prone to heavy bleeding. So what are the principles for treating postpartum hemorrhage in women? The following editor will introduce to you

Principles of management of postpartum hemorrhage

1. Soft birth canal laceration: The effective measure to stop bleeding is timely and accurate repair and suturing. Cervical lacerations should be sutured with intestinal suture. The first stitch should start slightly above the top of the laceration, and the last stitch should end 0.5 cm away from the outer end of the cervix. When suturing vaginal lacerations, care should be taken to sew to the bottom to avoid leaving dead space and to avoid the sutures passing through the rectum.

2. Placental factors: Incomplete placental separation, retention and adhesion are removed by manual separation. Use a large scraper to scrape off any remaining residue. Placenta accreta should be examined by laparotomy with the uterus opened, and subtotal hysterectomy should be performed if confirmed. If the placenta is stuck above the uterine constriction ring, ether anesthesia is used to relax the constriction ring and the placenta is removed manually.

3. Coagulation dysfunction: In early pregnancy, artificial abortion should be performed as soon as possible to terminate the pregnancy. If the disease is discovered in the middle or late stages of pregnancy, efforts should be made to eliminate the cause or significantly improve the condition. During delivery, while the cause is being treated, any excessive bleeding should be dealt with, with medication used to improve coagulation function and fresh blood transfusions. In the treatment of postpartum hemorrhage, while stopping the bleeding, the hemorrhagic shock should be dealt with seriously, the patient's condition should be improved and antibiotics should be used to control the infection.

4. Weak uterine contractions: Strengthening uterine contractions is a method of stopping bleeding that has a certain effect. When massaging the uterus, it is important to emphasize holding the uterus with your hands. The massage should be done until the uterus returns to normal contraction and can maintain the contracted state. While massaging, slowly inject 10 units of oxytocin into 20 ml of 25% glucose solution intramuscularly or intravenously, followed by 0.2 mg of ergonovine intramuscularly or intravenously. Use with caution in patients with heart disease. Then add 20-30 units of oxytocin to 500 ml of 10% glucose solution and drip it intravenously.

Understanding the principles of treatment for postpartum hemorrhage will help to deal with it in a timely manner and avoid dangerous situations.

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