Skip to main content

Table 3 Interviews with obstetric health care providers on the standard local care regarding PPH

From: Bottom-up development of national obstetric guidelines in middle-income country Suriname

Post partum hemorrhage n = 43 (100%)
Definitions clear
 PPH 38 (88)
 Severe PPH 19 (44)
 Clear when to alarm doctor 24 (56)
Anticipation / prevention
 Uterotonics in Caesarean 43 (100)
 Uterotonics in all vaginal births 14 (33)
 Controlled cord traction 19 (44)
Measuring blood
 Measuring by cup 18 (42)
 Only clots measured 16 (37)
Medical treatment (1st line)
 Oxytocin i.m. or i.v. (2nd shot) 16 (37)
 Oxytocin infusion (10IU/4 hrs) 43 (100)
 Misoprostol 400mcg supp 41 (95)
 Methergine 0.2mg i.m. 11 (26)
Resuscitation
 Always place 2nd i.v. line 11 (26)
 Choice of fluids:
  Crystalloids 43 (100)
  Colloids 16 (37)
 Oxygen 20 (47)
 Tranexamic acid (1 gr i.v.) 10 (23)
Blood transfusion
 Clear guidelines available 0 (0)
 Indication:
  Hb < 4 mmol/L 37 (86)
  Hb < 3.5 + Ht <0.20 6 (14)
  Persistent blood loss 43 (100)
 Ratio:
  1 PC : 2 FFP 9 (21)
  2 PC : 1 FFP 34 (79)
Other
 PPH box availablea 19 (44)
 Balloon / B-Lynch / uterine pack 0 (0)
 Vaginal tampon 43 (100)
 Hysterectomy if necessary 43 (100)
 Early warning score (MEOWS) 9 (21)
  1. aPPH box includes oxytocin, Methergin, misoprostol, different IV cannulas, blood sample bottles, tourniquet, syringes, plaster to fix cannula, catheter size 16 with urobag, infusion set, blood set, sterile gloves, cotton swabs, scissors, fluids (ringers lactate and sodiumchloride), 3-way connectors, oxygen face mask, spculums, sponge holding forceps, condom tamponade and catheter, uterine pack