What is the initial nonpharmacologic intervention for postpartum hemorrhage caused by involution failure?

The initial nonpharmacologic intervention for postpartum hemorrhage due to involution failure is external or bimanual uterine massage. This technique is critical because it helps stimulate uterine contractions, which can assist in reducing bleeding by promoting uterine tone. Involution failure often results in a uterus that is not contracting effectively, leading to excessive blood loss. By applying pressure through massage, the practitioner can encourage the uterus to contract and thus decrease the risk of continued hemorrhage.

Other interventions may play a role in post-hemorrhage care, but they are not the first-line nonpharmacologic approach. The insertion of an indwelling Foley catheter is more of a supportive measure to monitor urine output or relieve bladder distension but does not address the underlying issue of uterine atony directly. Similarly, pulse oximetry and cardiac monitoring are important for assessing the mother’s condition but do not contribute to resolving uterine atony specifically. The Reverse Trendelenburg position may be utilized to improve venous return in cases of hypotension or hypovolemia, but it does not directly stimulate the uterus to contract, making uterine massage the preferred initial intervention in managing this situation.