Coagulopathy worsens bleeding and limits uterotonic response
Neonatal transition failure
Inadequate lung aeration as primary driver of bradycardia
Therapeutic Considerations
Evidence based principles
Oxytocin first line for PPH prevention and treatment (FIGO 2022)
Combined uterotonic therapy reduces PPH risk more than oxytocin alone (review data)
Early TXA improves outcomes when given within 3 h for PPH (WHO recommendation)
Ventilation is the key neonatal resuscitation intervention
Delayed ventilation increases risk of death (AHA neonatal resuscitation guidance)
Chest compressions reserved for persistent bradycardia after effective ventilation (AHA 2020)
Patient Discharge Instructions
copy discharge instructions
Post delivery discharge guidance
Expected course
Vaginal bleeding similar to heavy period then tapering
Cramping with uterine involution
Return immediately criteria
Soaking more than 1 pad per hour for 2 h
Passing large clots
Dizziness or fainting
Fever
Severe headache or vision changes
Chest pain or shortness of breath
Severe abdominal pain
Wound care
Perineal hygiene
Sitz baths if recommended
Follow up
Obstetric follow up within 1 week if any complication
Routine postpartum visit scheduling
Newborn red flags
Poor feeding
Lethargy
Breathing difficulty
Fever or hypothermia
Jaundice progression
References
Clinical guidelines and key sources
Evidence sources
American Heart Association neonatal resuscitation guidance and updates (AHA 2020 and 2023 focused update)
Neonatal Resuscitation Program practice resources and medication card (PHSA NRP resources)
WHO recommendation on tranexamic acid for postpartum hemorrhage
FIGO recommendations on postpartum hemorrhage management and uterotonic dosing
SOGC Guideline No. 431 postpartum hemorrhage and hemorrhagic shock considerations
AAFP shoulder dystocia management review
NHS Scotland shoulder dystocia guideline
NHS Scotland intrapartum breech delivery guidance
Project instruction source
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.