Post-partum haemorrhage - Treatement

General measures should be initiated immediately to stop the bleeding. Depending on the cause of bleeding required a series of specific measures.
Among general measures include:- In the presence of external bleeding uterus appeared to be massaged if it is not firmly contracted, and if signs of placental separation are present, expression of placenta, uterine exerting pressure on the bottom should be done;- Manual extraction of placenta is performed immediately post-partum. This maneuver is performed under general anesthesia (intravenous);- Control of the vaginal walls, the cervix, to identify their business continuity and suture;- After delivery of the placenta, uterine palpation is mandatory to check if it is well contracted;- Intramuscular or intravenous administration or ergomet Methergin or oxytocin (20 U in 1000 ml Ringer's solution or saline). Injection can be done and Cervical;- Intramuscular administration of prostaglandin;- Continued bleeding despite the measures taken require a second venous access, blood transfusion, infusion of blood substitute chemicals, yarn hemo, hemostatic threads- Message boards long uterine cavity is not advisable because gravid uterus may not be well kept fixed, immediately after his birth dilatandu the following message and can hide the extra blood loss.Measures in particular situations, depending on the causes of bleeding are:
1. In the case of intravenous administration of oxytocin, uterine atoniei and / or muscle may reverse the ergomet atony. Intramuscular injection of prostaglandin analogues are effective in treating uterine atoniei.2. Retention of placental fragments require manual control of the uterine cavity, which can sometimes be followed by instrumental control.3. Hemorrhage secondary genital tract continuity solutions require immediate suture.4. Bleeding through consumption coagulopathy requiring aggressive therapy that is based on: the use of fresh blood, platelet replacement by administration of fresh blood or platelet concentrates, fibrinogen replacement by administration of cryoprecipitate or plasma, replacement of coagulation factors by administration of fresh blood or cryoprecipitate.