Postpartum Hemorrhage (PPH) is the leading cause of maternal mortality worldwide. It is defined as a blood loss of 500 mL or more within 24 hours of delivery. PPH can be caused by a number of factors, including:

• Uterine atony (failure of the uterus to contract properly after delivery)
• Retained placenta (failure of the placenta to be delivered within 30 minutes after delivery)
• Lacerations of the cervix, vagina, or uterus
• Coagulopathies (bleeding disorders)

Risk factors for PPH include:

• Previous PPH
• Uterine atony
• Preeclampsia/eclampsia
• Multiple gestation
• Macrosomia (fetal weight greater than 4 kg)
• Amniotic fluid embolism
• Traumatic delivery
• Coagulopathies

Nurses can play a vital role in preventing and managing PPH. By assessing for risk factors and being prepared for an event, nurses can help to ensure that women with PPH receive prompt and effective treatment.

Nursing interventions for PPH include:

• Assessment: Nurses should assess the woman’s vital signs, blood loss, and uterine tone. They should also inspect the perineum and vagina for lacerations.
• Management: Initial management of PPH includes:
  • Uterine massage: This helps to stimulate contractions and expel clots from the uterus.
  • Oxytocin administration: Oxytocin is a hormone that causes the uterus to contract.
  • Fluid resuscitation: This is necessary to replace the lost blood volume.
  • Blood transfusion: This may be necessary if the woman has lost a significant amount of blood.
• Referral: If the woman’s bleeding does not respond to initial management, she should be referred to a physician for further evaluation and treatment.

Nurses can also play a role in educating women about PPH and its risk factors. This education can help women to identify the signs and symptoms of PPH and to seek medical attention promptly if they experience any concerns.

Here are some specific examples of how nurses can impact the statistics on PPH:

• Assess all women for risk factors for PPH. This should be done during prenatal care and at the time of delivery.
• Be prepared to manage PPH. This includes having the necessary equipment and supplies available, and being familiar with the latest evidence-based treatment guidelines.
• Intervene emergently if PPH occurs. This may include administering uterotonics, providing fluid resuscitation, and/or arranging for a blood transfusion.
• Educate women about PPH. This includes teaching them about the signs and symptoms of PPH, and the importance of seeking medical attention promptly if they experience any concerns.

By taking these steps, nurses can help to reduce the number of women who experience PPH and its associated complications.