NGN Case Study: Postpartum Hemorrhage Walkthrough
PPH from immediate post-delivery through stabilization.
PPH cases test 4 Ts and pharmacologic management.
Presentation
30 y/o G3P3 1h post vaginal delivery. Boggy fundus, gushing bleed. BP 90/55, HR 122. EBL >1000 mL.
Recognize
Uterine atony pattern. Hemodynamic compromise.
Prioritize
Fundal massage first. Empty bladder. Oxytocin running.
Take action
Methylergonovine IM (if not hypertensive). Carboprost IM (if not asthmatic). Misoprostol rectal. Tranexamic acid IV. Blood products. Possible balloon, surgery.
Evaluate
Firm fundus, decreased bleeding, BP stable, HR down.
Frequently asked
First-line if methergine contraindicated?
Carboprost, unless asthma.
Quick check
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