Postpartum Hemorrhage - Differential Diagnosis, Examination ...
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Postpartum Hemorrhage - Differential Diagnosis, Examination and Management



Uterotonic Medications (after delivery of the placenta):

 • Oxytocin (causes uterine contraction): 10 IU IM or 20 IU in 500 mL IV fluids at 250 mL/hr

 • RAPID IV INFUSION IS ASSOCIATED WITH CARDIOVASCULAR COLLAPSE

 • Methylergonovine (causes uterine contraction): 0.2 mg IM (avoid in preeclampsia or hypertension)

 • Carboprost (prostaglandin that induces uterine contraction: 0.25 mcg IM q15 min up to 2 mg (8 doses)

 • Misoprostol (prostaglandin that induces uterine contraction): 600-1000 mcg oral/rectal

 • OFF LABEL USE

Methods of Tamponade:

 • Balloon uterine tamponade device (Bakri)

 • Foley catheter is not large enough to provide tamponade

 • Uterine packing may not be effective as the uterus may create and large potential space

Surgical/Vascular Intervention:

 • Hysterectomy

 • Uterine Artery Embolization



by Stacy Marshall, MD



#Postpartum #Hemorrhage #Differential #Diagnosis #Examination #Management #Medications 
Contributed by

Dr. Gerald Diaz
@GeraldMD
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG:  https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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