产后出血：产后出血的预防、诊断和治疗课程

Course on prevention, diagnosis andtreatment of postpartum haemorrhage Bleeding after birth: course on prevention, diagnosis and treatment of postpartumhaemorrhage. ISBN 978-92-4-011583-5 (print version) Contents ISBN 978-92-4-011584-2 (electronic version) AcknowledgementsivAcronyms and abbreviationsvPlan and prepare to facilitate a course1Using this Flip Chart to facilitate learning1b © World Health Organization 2025 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). 1.Saving lives at birth2Main causes of bleeding after birth3Provide respectful care and prevent infection4Prepare for birth, check equipment and medications5Assess and record6 Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercialpurposes, provided the work is appropriately cited, as indicated below. In any use of this work,there should be no suggestion that WHO endorses any specific organization, products or services.The use of the WHO logo is not permitted. If you adapt the work, then you must license your workunder the same or equivalent Creative Commons licence. If you create a translation of this work,you should add the following disclaimer along with the suggested citation: “This translation wasnot created by the World Health Organization (WHO). WHO is not responsible for the content oraccuracy of this translation. The original English edition shall be the binding and authentic edition”. 2.Prevention and early diagnosis of PPH7Give a uterotonic within 1 min8Start measuring blood loss9How accurate is visual estimation of blood loss?10Be alert.If PPH, start bundle11Cut the cord and perform controlled cord traction12Check tone, massage if soft, check bleeding13Check placenta14Check for tears and repair15Continue care for woman and baby16Scenario practice 117Empty bladder and repeat controlled cord traction18Remove manually19 Any mediation relating to disputes arising under the licence shall be conducted in accordancewith the mediation rules of the World Intellectual Property Organization. Suggested citation.Bleeding after birth: course on prevention, diagnosis and treatment ofpostpartum haemorrhage. Geneva: World Health Organization; 2025. Licence: CC BY-NC-SA 3.0IGO. Cataloguing-in-Publication (CIP) data.CIP data are available athttp://apps.who.int/iris. 3.Treatment with the PPH bundle20Call for help21Start PPH bundle22Examine and address causes23Scenario practice 224Scenario practice 325Scenario practice 426 Sales, rights and licensing.To purchase WHO publications, see http://apps.who.int/bookorders.To submit requests for commercial use and queries on rights and licensing, see http://www.who.int/about/licensing. Third-party materials.If you wish to reuse material from this work that is attributed to a thirdparty, such as tables, figures or images, it is your responsibility to determine whether permissionis needed for that reuse and to obtain permission from the copyright holder. The risk of claimsresulting from infringement of any third-party-owned component in the work rests solely with theuser. 4.Continued treatment if bleeding persists27Arrange transfer or surgery28 Rapidly apply NASG29Skills practice –NASG30Continue massage, catheterize bladder, remove clots/debris31Start second IV, give additional uterotonics and TXA second dose, assess and record32Scenario practice 533 General disclaimers.The designations employed and the presentation of the material inthis publication do not imply the expression of any opinion whatsoever on the part of WHOconcerning the legal status of any country, territory, city or area or of its authorities, or concerningthe delimitation of its frontiers or boundaries. Dotted and dashed lines on maps representapproximate border lines for which there may not yet be full agreement. 5.Advanced interventions and post-PPH care34Bimanual compression35Insert uterine balloon tamponade36Repair deep tears37Provide post-PPH care38 The mention of specific companies or of certain manufacturers’ products does not imply that theyare endorsed or recommended by WHO in preference to others of a similar nature that are notmentioned. Errors and omissions excepted, the names of proprietary products are distinguishedby initial capital letters. All reasonable precautions have been taken by WHO to verify theinformation contained in this publication. However, the published material is being distributedwithout warranty of any kind, either expressed or implied. The responsibility for the interpretationand use of the material lies with the reader. In no event shall WHO be liable for damages arisingfrom its use. 6.Ongoing practice and quality improvement39References39b Acknowledgements Acronyms and abbreviations The World Health Organization (WHO) acknowledges the contributions of individuals andpartner organizations to the