Case of the Month #45 Major Obstetric Haemorrhage - Part 2

Published 16/11/2023

What is the care following MOH?

A careful post-haemorrhage care plan should be initiated. This includes: 

  • Level of care required (Enhanced Maternal Care on labour ward, HDU or ICU).  

  • Women with blood loss > 1500 ml should have a minimum of 6 hours enhanced maternal care. 

  • Monitoring and plan for removal of any packs/ balloons. 

  • Post op medications - can NSAIDS/ thromboprophylaxis be given? 

  • Time for taking post op bloods. 

  • PV loss monitoring. 

  • Hourly urine output monitoring. 

  • Clear parameters set for observations that should trigger further escalation. 

  • Ensure clear documentation of events, observations, fluid balance, blood/ blood component administration, drugs, interventions, and surgical procedures. 

A debrief with both the obstetric and anaesthetic teams involved should be offered to the woman and her birthing partner(s) following MOH, when the women has recovered from the initial event, at a time that is mutually convenient.  

It is recommended that the team of all staff involved also conduct a debrief amongst themselves, so support can be offered.