The color is dark red, the uterus is soft and the outline is unclear.

Heavy vaginal bleeding, dark red in color

Vaginal bleeding occurs immediately and is bright red in color.

Persistent vaginal bleeding after delivery of the fetus or placenta, and the blood does not coagulate

If the bleeding rate is >150ml/min, the bleeding volume within 3 hours exceeds 50% of the total blood volume, and the bleeding volume within 24 hours exceeds the whole body heavy blood volume, it is considered severe postpartum hemorrhage.

In the early stage of bleeding, the body's compensatory function means the signs and symptoms are not obvious; in the decompensation stage, the body immediately enters a state of shock.

The estimated blood loss is 400~500ml for every 10g/L drop in hemoglobin.

Central venous pressure lower than 2cmH₂O often indicates insufficient filling pressure of the right atrium, that is, insufficient venous blood return and insufficient blood volume.

Strengthen health care during pregnancy and conduct regular prenatal check-ups

Provide psychological support

High-risk pregnant women should be transferred to a hospital with blood transfusion and rescue facilities before delivery.

first stage of labor

second stage of labor

third stage of labor

Two hours after delivery is the peak period for postpartum hemorrhage. After delivery, the mother should stay in the delivery room for close observation

Encourage mothers to empty their bladders promptly and breastfeed as early as possible

Pregnant women at high risk for severe bleeding should maintain intravenous access, be prepared for blood transfusion and first aid, and keep the mother warm.

Massage the uterus

Apply uterotonics

uterine tamponade

uterine compression suture

ligation of pelvic blood vessels

transcatheter arterial embolization

hysterectomy

retained placenta

placenta accreta

Retained placenta

Cervical laceration <1cm and no active bleeding: usually no suturing is required Lacerations >1cm with active bleeding: should be sutured immediately

Supplement clotting factors

Keep the airway open, give oxygen, quickly establish double venous channels, and replenish blood volume in a timely manner. When blood pressure is low, vasopressor drugs and adrenocortical hormones can be used

The uterus has tonic or spasmodic contractions that are too strong and the pain is unbearable

When the descent of the fetal presenting part is blocked and the uterus contracts too strongly, the strong uterine contractions will cause the lower uterine segment muscles to be extremely stretched and thinned, while the uterine body muscles will be extremely thickened and shortened, forming an obvious annular depression between the two. It is called a pathological condensation ring. Uterine tenderness is obvious, and the ring can gradually rise to the umbilicus or above the umbilicus

Partial or full-thickness rupture of the myometrium, but the serosa layer is intact, and the uterine cavity and peritoneum are not connected

Full-thickness rupture of the uterine wall, communicating with the uterine cavity and abdominal cavity

Keep airway open

Maintain hemodynamic stability

Relieve pulmonary hypertension

liquid management

Treatment during cardiac arrest

High-dose glucocorticoids

Heparin is not often recommended

If amniotic fluid embolism occurs in front of you, immediate termination of pregnancy should be considered; if coagulation dysfunction occurs, hysterectomy should be performed quickly