Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
If a patient presents with signs of postpartum haemorrhage in the primary care setting, the immediate management steps are critical and require prompt action:
- Call for immediate help NICE NG235.
- Arrange for transfer of the woman to obstetric-led care NICE NG235. This is crucial, especially if the patient is not already in an obstetric unit or if the placenta is retained NICE NG235.
- If there are signs of shock, such as pallor, tachycardia, hypotension, or collapse, or if there is significant concern about the degree of bleeding or pain, arrange for immediate hospital admission, potentially directly to Accident and Emergency NICE CKS,NICE CKS. Immediate resuscitation with intravenous fluids should be considered if available NICE CKS.
- While awaiting transfer and medical assistance, be aware that immediate clinical treatment involves emptying the bladder, uterine massage, administration of uterotonic drugs, and intravenous fluids NICE NG235. Supplementary oxygen, starting at 15 L/minute via a non-rebreathing mask with a reservoir bag, should also be considered NICE NG235.
- Continuously assess blood loss and the woman's condition to identify the source of the bleeding NICE NG235.