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Bleeding Relaxed uterus Placental in Manual removal Placental out Uterine massage and uterotonics Bleeding removed Not removed (accreta) Surgical repair Contracted Abnormal Laparotomy 1.Hypogastric arteri ligation 2.Uterine artery ligation 3. Hysterekstomi 4. Repair of uterus No bleeding Replace defect Normal Evaluate coagulation Uterus contracted Inspect for lower genital laceration
Inspect uterus Laceration
Manual removal andn curettage
sumber : Fadel 1988