12.5.2
Secondary PPH
Malawi Standard Treatment Guidelines, 6th Edition, 2023. Chapter 12, Sexual and Reproductive Health.
Clinical Description
Bleeding from the genital tract 24 hours post-delivery until 42 days
Causes: Retained products, often with infection, endomyometritis
Pharmacological
- Set up an IV line and resuscitate
- Replace blood loss with IV fluids/blood
- Empty bladder
- Rub up a contraction
- Give Oxytocin 10 units IM
- If patient is septic start antibiotics
- Give Ceftriaxone 2g iv daily and Metronidazole 400 mg 8 hourly
- OR Ampicillin 1g 6 hourly/ Benzyl penicillin 2 MU IV 6 hourly, Gentamycin 240mg daily, Metronidazole 5 0 0 mg 8 hourly
- Second line: Meropenem 1 g 8 hourly
Check doses against the printed guideline and your clinical judgement before treating a patient. Spotted an error? Report it from the contact links below.
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