A review of the current management  of postpartum haemorrhage in the  Republic of Ireland, using a case  study approach

Fitzgerald, Imelda; O'Connell, Rhona; Hughes, Paul; Lyons, Priscilla; McKernan, Joye; Greene, Richard; Corcoran, Paul

A review of the current management of postpartum haemorrhage in the Republic of Ireland, using a case study approach

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Fitzgerald et al 2022 2.pdf(258.44 KB)

Published version

Date

2022-12

Authors

Fitzgerald, Imelda

O'Connell, Rhona

Hughes, Paul

Lyons, Priscilla

McKernan, Joye

Greene, Richard

Corcoran, Paul

Publisher

MIDIRS

Abstract

Objective: To get a better understanding of the steps taken during a postpartum haemorrhage (PPH) in the Republic of Ireland. Design: Population-based retrospective cohort study. Hospital births in Ireland during 2020. Methods: A PPH proforma data collection tool was used to understand what occurred during each PPH, the management provided to the woman and the medication received. Main outcomes: Escalation of care to multidisciplinary team (MDT), mode of birth, quantifying blood loss. Results: The 53 PPH proformas collected from two maternity units were comprised of: 43 per cent (23) mild PPH (500–1000ml); 34 per cent (18) moderate PPH (1000–1500ml); and 22 per cent (12) severe PPH (over 1500ml). The blood volume ranged from 500ml to 4.1litres. The most immediate response on recognition of a PPH, by midwives or obstetric doctors who diagnosed the blood loss following childbirth as excessive, was to administer a Syntocinon infusion as the first line of treatment. Conclusions: Potential improvements for care during a PPH include: the first treatment of ‘hand on fundus, call for help’; midwives managing the PPH with use of other treatments and medications while escalating care; timely escalation of emergency phone; an MDT approach to manage the PPH; and quantification of blood loss.

Keywords

Ireland , Postpartum haemorrhage , Childbirth

Citation

Fitzgerald, I., O’Connell, R., Hughes, P., Lyons P., McKernan, J., Greene, R. and Corcoran, P. (2022) ‘A review of the current management of postpartum haemorrhage in the Republic of Ireland, using a case study approach’, MIDIRS Midwifery Digest, 32 (4). pp. 505-511