Postpartum hemorrhage

The learner should be able to:

• Recognize rapidly clinical signs of “postpartum hemorrhage”.
• Mobilize available resources that allow the management of Postpartum Hemorrhage according to reference algorithm
• Recognize the clinical signs of uterine atony.
• Start basic resuscitation
•  Coordinate the implementation of clinical and biological monitoring with the team
• Perform a systematic uterine revision while respecting the rules of rigorous asepsis
• Perform a vaginal exam while respecting the rules of asepsis and the safety of the parturient.
• Perform uterine massage to promote uterine tonicity.
• Maintain a safe uterine globe by placing a sandbag on the uterine fundus.
• Insert a catheter in the bladder while respecting the strict asepsis rules.
•  Administer uterotonics drugs according to the reference protocols.
•  Ensure rigorous monitoring of hemodynamic stability.

32-year-old woman, 3rd gesture 2nd parity with 40 weeks of amenorrhea (Blood group: O positive). Without antecedent.
She came to the maternity ward at 3 am with amniotic fluid discharge for 2 hours and pelvic pain.