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) |