Thursday, 26 November 2009

Mnemonic for Obstetric Haemorrhage

Management of Atonic Obstetric Haemorrhage-"HAEMOSTASIS"

General medical management

H-call for help

A-assess (vital signs/blood loss) & resuscitate

E-Establish aeitiology(4T-Tone/Tissue/ Trauma/Thrombin)

E-Ecbolics(syntometrine/ergometrine/bolus syntocinon)

E-Ensure availability of blood products

M-Massage the uterus

O-Oxytocin infusion,prostaglandins(intravenous,rectal,intramuscular,intramyometrial)

Specific surgical management

S-shift to operating theatre(bimanual compression anti-shock garment,especially if tranfer is required

T-Tissue & trauma to be exculded & balloon tamponade or uterine packing

A-apply compression sutures

S-sytematic pelvic devascularisation(uterine,ovarian,quadruple,internal iliac)

I-interventional radiology,uterine artery embolisation

S-Subtotal/Total hysterectomy


Mukherjee S, Arulkumaran S. Post-partum haemorrhage. Obstetrics, Gynaecology & Reproductive Medicine. 2009 5;19(5):121-126.

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