Table 3.
Interviews with obstetric health care providers on the standard local care regarding PPH
| Post partum hemorrhage | n = 43 (100%) |
|---|---|
| Definitions clear | |
| PPH | 38 (88) |
| Severe PPH | 19 (44) |
| Clear when to alarm doctor | 24 (56) |
| Anticipation / prevention | |
| Uterotonics in Caesarean | 43 (100) |
| Uterotonics in all vaginal births | 14 (33) |
| Controlled cord traction | 19 (44) |
| Measuring blood | |
| Measuring by cup | 18 (42) |
| Only clots measured | 16 (37) |
| Medical treatment (1st line) | |
| Oxytocin i.m. or i.v. (2nd shot) | 16 (37) |
| Oxytocin infusion (10IU/4 hrs) | 43 (100) |
| Misoprostol 400mcg supp | 41 (95) |
| Methergine 0.2mg i.m. | 11 (26) |
| Resuscitation | |
| Always place 2nd i.v. line | 11 (26) |
| Choice of fluids: | |
| Crystalloids | 43 (100) |
| Colloids | 16 (37) |
| Oxygen | 20 (47) |
| Tranexamic acid (1 gr i.v.) | 10 (23) |
| Blood transfusion | |
| Clear guidelines available | 0 (0) |
| Indication: | |
| Hb < 4 mmol/L | 37 (86) |
| Hb < 3.5 + Ht <0.20 | 6 (14) |
| Persistent blood loss | 43 (100) |
| Ratio: | |
| 1 PC : 2 FFP | 9 (21) |
| 2 PC : 1 FFP | 34 (79) |
| Other | |
| PPH box availablea | 19 (44) |
| Balloon / B-Lynch / uterine pack | 0 (0) |
| Vaginal tampon | 43 (100) |
| Hysterectomy if necessary | 43 (100) |
| Early warning score (MEOWS) | 9 (21) |
aPPH box includes oxytocin, Methergin, misoprostol, different IV cannulas, blood sample bottles, tourniquet, syringes, plaster to fix cannula, catheter size 16 with urobag, infusion set, blood set, sterile gloves, cotton swabs, scissors, fluids (ringers lactate and sodiumchloride), 3-way connectors, oxygen face mask, spculums, sponge holding forceps, condom tamponade and catheter, uterine pack