Early Postpartum Haemorrhage Nursing Care Plan &
Management
,
, Description
1. Early postpartum haemorrhage is defined as blood loss of 500 mL or
more during the first 24 hours after delivery.
2. Post-partum haemorrhage is the leading cause of maternal death
worldwide and a common cause of excessive blood loss during the
early postpartum period.
3. Approximately 5% of women experience some type of postdelivery
haemorrhage.
Aetiology
1. Major causes of postpartum haemorrhage are uterine atony
(responsible for at least 80% of all early postpartum haemorrhages);
laceration of cervix, vagina, or perineum; and retained placental
fragments.
2. Predisposing factors include hypotonic contractions, overdistended
uterus, multiparity, large new born, forceps delivery, and caesarean
delivery.
Pathophysiology
▪ The uterus is unable to contract effectively and maintain
haemostasis.
Assessment Findings
Clinical manifestations include:
1. Vaginal bleeding.
2. Hypotonic uterus.
3. Excessive blood loss, which may produce hypotension, thread pulse,
pallor, restlessness, dyspnoea, and chills.
Nursing Management
1. Assist with appropriate treatment to prevent complications.
▪ Determine the presence of uterine firmness and location and amount
of vaginal bleeding immediately after delivery.
▪ Measure and record serial maternal vital signs after delivery- every 5
to 15 minutes until stable; increase or decrease the frequency of
assessment relative to baseline and amount of bleeding.
▪ Notify the practitioner of abnormal assessment findings.
▪ Massage the fundus gently, taking care to support the uterus with the
hand just above the symphysis pubis.
▪ Administer medications as prescribed.
▪ Keep an accurate pad count (100 mL per saturated pad).
▪ Assess condition of skin, urine output, and level of consciousness.
Management
,
, Description
1. Early postpartum haemorrhage is defined as blood loss of 500 mL or
more during the first 24 hours after delivery.
2. Post-partum haemorrhage is the leading cause of maternal death
worldwide and a common cause of excessive blood loss during the
early postpartum period.
3. Approximately 5% of women experience some type of postdelivery
haemorrhage.
Aetiology
1. Major causes of postpartum haemorrhage are uterine atony
(responsible for at least 80% of all early postpartum haemorrhages);
laceration of cervix, vagina, or perineum; and retained placental
fragments.
2. Predisposing factors include hypotonic contractions, overdistended
uterus, multiparity, large new born, forceps delivery, and caesarean
delivery.
Pathophysiology
▪ The uterus is unable to contract effectively and maintain
haemostasis.
Assessment Findings
Clinical manifestations include:
1. Vaginal bleeding.
2. Hypotonic uterus.
3. Excessive blood loss, which may produce hypotension, thread pulse,
pallor, restlessness, dyspnoea, and chills.
Nursing Management
1. Assist with appropriate treatment to prevent complications.
▪ Determine the presence of uterine firmness and location and amount
of vaginal bleeding immediately after delivery.
▪ Measure and record serial maternal vital signs after delivery- every 5
to 15 minutes until stable; increase or decrease the frequency of
assessment relative to baseline and amount of bleeding.
▪ Notify the practitioner of abnormal assessment findings.
▪ Massage the fundus gently, taking care to support the uterus with the
hand just above the symphysis pubis.
▪ Administer medications as prescribed.
▪ Keep an accurate pad count (100 mL per saturated pad).
▪ Assess condition of skin, urine output, and level of consciousness.
