What is included in fluid resuscitation monitoring during the treatment of postpartum hemorrhage (PPH)?

Updated: Jun 27, 2018
  • Author: John R Smith, MD, FACOG, FRCSC; Chief Editor: Ronald M Ramus, MD  more...
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Answer

Pay close attention to the patient’s level of consciousness, pulse, blood pressure, and urine output during the course of the management of massive hemorrhage. A urine output of 30 mL/h or more likely indicates adequate renal perfusion. Closely monitor the CBC count, coagulation, and blood gas values in addition to acid-base status. Pulse oximetry is useful for evaluating tissue perfusion and oxygen saturation. Frequent auscultation of the lung fields helps detect pulmonary edema or the development of adult respiratory distress syndrome. For patients in critical condition with ongoing bleeding, the placement of a central venous line may be helpful for resuscitation. Arterial line placement also may aid in monitoring blood pressure and allowing easy access for blood work. Few patients experiencing PPH require such invasive monitoring; however, consultation with appropriate specialists and placement in an intensive care setting are preferred for those who do.


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