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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