IMG_0028.jpeg

# Postpartum Hemorrhage **Blood loss** greater than 500mL (vaginal) or 1000mL (cesarean). **Causes:** * Bladder distention * Abnormal or prolonged labor * Overdistended uterus * Multiparity (five or more births) * Use of oxytocin during labor * Medications that relax the uterus * Op...

# Postpartum Hemorrhage **Blood loss** greater than 500mL (vaginal) or 1000mL (cesarean). **Causes:** * Bladder distention * Abnormal or prolonged labor * Overdistended uterus * Multiparity (five or more births) * Use of oxytocin during labor * Medications that relax the uterus * Operative birth * Low placental implantation * Rapid labor * Use of instruments (e.g., forceps or vacuum extractor) during birth * Prolonged or rapid labor * Large infant (macrosomia) * Use of forceps or vacuum extractor # Fundal Assessment * Should be midline and firm * Boggy fundus (massage boggy deviated fundus) - take patient to the bathroom if stable. * Palpate bladder if distended * Change pad to monitor bleeding **Medications to stimulate uterine contraction:** * Oxytocin (Pitocin): Often given routinely via IV infusion after birth. * Methylergonovine (Methergine): Given intramuscularly or orally. **Date:** 12/9/2024