Prevention of PPH
1 . Administer oxytocin routinely after delivery
2 . Clamp and cut cord when baby delivered (delay clamping by 60 sec if <37wks GA)
3 . Palpate uterine fundus and confirm that uterus is contracting
4 . Keep tension on cord pulling gently while applying suprapubic counter-traction on uterus with other hand. Digital exam along the cord to determine whether the placenta is at the
cervix. Pulling hard on cord may cause cord to avulse. Gentle traction with a relaxed uterus can cause uterine inversion.
5 . If placenta not delivered in 15 minutes, use oxytocin infusion
6 . Once placenta delivered, assess fundus to ensure it is well contracted
7 . Inspect placenta and membranes for completeness
8 . Examine external genitalia and internal genital tract for lacerations, hematomas.
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