Manually explore the uterus when cervical dilation permits, otherwise perform digital curettage (Chapter 9, Section 9.4) or instrumental curettage with the widest curette available (Chapter 9, Section 9.6) and administer a uterotonic agent ( oxytocin IM or slow IV: 5 to 10 UI, or, if not available, methylergometrine IM: 0.2 mg or misoprostol sublingually: 800 micrograms).Ratio 7:1: 2625 mg daily (1 tablet of 875/125 mg 3 times daily)Īmoxicillin PO: 1 g 3 times daily + metronidazole PO: 500 mg 3 times daily, to complete 5 days of treatment Ratio 8:1: 3000 mg daily (2 tablets of 500/62.5 mg 3 times daily) It needs to be treated early to avoid complications. Administer immediately an antibiotherapy:Īmoxicillin/clavulanic acid IV (dose expressed in amoxicillin): 1 g every 8 hours + gentamicin IM: 5 mg/kg once dailyĪmpicillin IV: 2 g every 8 hours + metronidazole IV: 500 mg every 8 hours + gentamicin IM: 5 mg/kg once dailyĬontinue until the fever disappears (at least for 48 hours), then change to:Īmoxicillin/clavulanic acid PO (dose expressed in amoxicillin) to complete 5 days of treatment A retained placenta is when part or all of the placenta is left in the womb after you have your baby.Rarely, persistent trophoblastic disease or choriocarcinoma. Postpartum hemorrhage is considered to be primary when it occurs within the first 24 hours after delivery and secondary when it occurs between 24 hours and up to 12 weeks after delivery.Retained placenta or blood clots with secondary infection (endometritis).8.3.1 DiagnosisĪ combination of the following signs: foul-smelling vaginal bleeding, fever, a uterus that is soft and larger than expected, general deterioration, anaemia. Feedback: The woman is at risk for thrombophlebitis due to the prolonged second stage of labor, necessitating an increased amount of time in bed, and venous pooling that occurs when. Excessive vaginal bleeding from 24 hours to 6 weeks after delivery.
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