การปองกันการตกเลือดใน2 ชั่วโมงแรกหลังคลอด:บทบาทผดุงครรภ์ First Two Hours Postpartum Hemorrhage Prevention: Midwives’ Role

บทคัดย่อ

Early vaginal postpartum hemorrhage (PPH) is defined as blood loss of 500 ml. or more during the first 24 hours after delivery, which mostly occurs within 2 hours after birth. Blood loss in the first 2 hours should not exceed 80 ml. and 160 ml. for the first 24 hours. Major causes of PPH for the first 2 hours are uterine atony; laceration of cervix, vagina, or perineum; retained placental fragments, and abnormal of coagulation.Prevention of PPH for the first 2 hours can be managed during pregnancy, intrapartum and postpartum period by screening for risk factors, applying proper childbirth and placental delivery technique, performing immediate uterine massage after birth and every 15 minutes until the fundus is firmly contracted, which takes approximately 5-10 minutes. Also, postpartum women and their relatives should be instructed to massage the uterus to decrease uterine bleeding.