Postpartum Haemorrhage (PPH)
🚨 Symptoms
Excessive bleeding after delivery (>500 ml vaginal birth, >1000 ml caesarean), tachycardia, hypotension, pallor, oliguria, altered consciousness, uterine atony (boggy uterus)
🔍 Causes
Tone (uterine atony – most common), Trauma (lacerations, uterine rupture, retained placenta), Tissue (retained products), Thrombin (coagulation disorders) – the 4 T's; risk factors: prolonged labour, large baby, multiple pregnancy, previous PPH, obesity
💊 Treatment
Uterine massage, oxytocin (IV/IM), ergometrine, misoprostol, tranexamic acid, bimanual compression, balloon tamponade (Bakri balloon), uterine packing, compression sutures (B-Lynch), hysterectomy as last resort, blood transfusion
📝 Nursing Care
Monitor vital signs frequently, assess uterine tone and bleeding, administer uterotonics, assist with procedures, monitor intake/output, prepare for transfusion, provide emotional support
Source: NHS Scotland. For educational purposes only.