CARE OF MOTHER IMMEDIATELY AFTER DELIVERY

TREATMENT

Monitoring of mother

  • Check every 15 minutes for 2 hours, then at 3 and 4 hours, then every 4 hours until discharge
    • Take the blood pressure
    • Rapid assessment for danger signs such as excessive PV bleeding, difficulty in breathing,
      severe headache
    • Feel if uterus is hard and round

Assess, classify, and treat

  • Raised diastolic blood pressure
    • >110 mmHg with proteinuria 3+ and signs/ sympotms of eclampsia: manage as severe
      eclampsia.
    • If 90-110 mmHg with proteinuria: manage as pre eclampsia
    • If >90 mmHg with no proteinuria and no symptoms of eclampsia: monitor and treat as
      hypertension 
  • Fever with chills or uterine tenderness or foul smelling discharge, treat as puerperal fever
    • If isolated raised temperature, monitor, hydrate
      and observe for 12 hours. Treat for pueperal fever if it persists
  • If bleeding perineal tear
    • Suture if trained or refer for further management
  • If bleeding (If pad soaked in <5 minutes or constant trickle of blood) and uterus not hard and
    around:

  • Anaemia: monitor for bleeding and look for conjunctival or palmar pallor, check Hb if
    indicated, manage as appropriate

Care of mother

  • Encourage mother to pass urine, eat, and drink
  • Ask the companion to stay with her