For a postpartum hemorrhage with placenta delivered and no baby complications, which protocol?

• A. Protocol 12
• B. Protocol 8
• C. Protocol 21
• D. Protocol 6

Answer: (C)

When a postpartum hemorrhage occurs after the placenta has been delivered and the newborn is not experiencing any complications, the main issue is uterine atony causing ongoing blood loss. The most effective approach is to restore and maintain uterine tone while supporting the mother. This means initiating uterotonic therapy as outlined in the protocol, performing fundal massage to stimulate contraction, securing two IV lines, starting isotonic fluids to replace lost blood volume, and monitoring vital signs and estimated blood loss. If available and within the protocol’s guidance, administer additional measures such as tranexamic acid and ensure rapid transport to a facility with obstetric capability if bleeding continues or worsens. Because the baby is stable, the focus remains on the mother’s hemorrhage control and stabilization.

Other protocols address different obstetric scenarios, such as fetal distress or placental issues that require alternate steps. The scenario described aligns with postpartum hemorrhage management after placenta delivery with a stable neonate, making the protocol that emphasizes uterine tone restoration and maternal stabilization the best fit.