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
- >110 mmHg with proteinuria 3+ and signs/ sympotms of eclampsia: manage as severe
- 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 isolated raised temperature, monitor, hydrate
- 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:- Treat as PPH
- 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