| 1 |
Assess
clotting status using a bedside clotting test. Failure
of a clot to form after 7 minutes or a soft clot that
breaks down easily suggests coagulopathy. |
| 2 |
Transfuse
as necessary. |
| 3 |
If
bleeding is heavy (evident or hidden), deliver as soon
as possible. |
| 4 |
If
the cervix is fully dilated, deliver by vacuum extraction. |
| 5 |
If
vaginal delivery is not imminent, deliver by caesarean
section. |
In every case of abruptio placentae, be prepared for postpartum haemorrhage.
|
| 6 |
If
bleeding is light to moderate (the mother is not in immediate
danger), the course of action depends on the fetal heart
sounds:
| • |
If
fetal heart rate is normal or absent, rupture the
membranes with an
amniotic hook or a Kocher clamp |
| • |
If
contractions are poor, augment labour with oxytocin |
| • |
If
the cervix is unfavourable (firm, thick, closed),
perform a caesarean section |
| • |
If
the fetal heart rate is less than 100 or more than
180 beats per minute:
– Perform rapid vaginal delivery
– If vaginal delivery is not possible, deliver by immediate caesarean
section. |
|
