12.5
Postpartum Haemorrhage (PPH)
Malawi Standard Treatment Guidelines, 6th Edition, 2023. Chapter 12, Sexual and Reproductive Health.
Clinical Description
Blood loss of greater than 500 mL after giving birth vaginally or a blood loss of greater than 1,000 mL after a cesarean section, or any amount of bleeding following delivery, that is significant enough to cause hemodynamic instability.
Signs and Symptoms
- Vaginal bleeding, pallor, hypotension, tachycardia, thirst, cold and clammy peripherals, increased capillary refill time.
Investigations
- FBC, sickling status
- Bedside clotting test
- Blood grouping and cross-matching
- Ultrasound scan (if patient is stable to check for retained placenta tissue)
- Thorough physical examination to look for genital tract trauma
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