What to do for postpartum hemorrhage

The principles of treatment for postpartum hemorrhage are rapid control of bleeding and active prevention and control of shock and infection. Rapid control of bleeding is the key to treatment and should be addressed for different causes. For bleeding caused by weak uterine contraction, strengthening uterine contraction is a quick and effective way to stop bleeding. The following measures can be taken after bladder evacuation: First, massage of the uterus is the most common method. Second, pharmacological treatment can be applied with constrictors, ergometrine, and prostaglandin-based preparations. Third, the uterine cavity is filled with gauze strips, long strips of gauze are filled in the uterine cavity to stop the bleeding by compression. Fourth, surgery, for those applicable to idiosyncratic injury or drug treatment failure, the blood vessels of the pelvic cavity can be ligated for intervention, it is not possible to have to perform hysterectomy. Fifth, for bleeding from lacerations of the soft birth canal, the soft birth canal should be carefully examined and sutured continuously or intermittently according to the anatomical level to stop the bleeding adequately. Sixthly, for placental factors, if the placenta has been aborted, the placenta should be removed quickly and the uterus should be massaged immediately. For placenta adhesions, freehand detachment can be performed. If there are placenta and fetal membrane residues, the uterine cavity can also be explored or scraped with bare hands, if necessary under anesthesia. Seventh, for abnormal coagulation function, fresh whole blood should be actively transfused, and platelets, fibrinogen and prothrombin complex should be supplemented to correct the abnormal coagulation function. For the treatment of hypovolemic shock, we should actively correct the shock while dealing with the etiology, establish effective intravenous access and monitor central venous blood pressure, replenish blood and crystals according to the principle of crystals first, then colloid, first fast then slow, fresh frozen plasma, etc., and give oxygen, correct acidosis, and pay attention to the prevention of infection and give effective antibiotics.