Postpartum Hemorrhage
Postpartum Hemorrhage (PPH), the leading cause of maternal mortality, is excessive blood loss following childbirth. PPH is defined as blood loss of more than 500 mL following vaginal delivery or more than 1000 mL following cesarean delivery. About 1-5% of women have PPH. It is most likely from cesarean birth. Hemorrhaging can occur right after delivery, but it can also occur later, following the delivery. The most common cause of postpartum hemorrhage is when the uterus does not contract enough after delivery. PPH can be diagnosed by an estimate of blood loss, measuring pulse and blood pressure, red blood cell count, and the clotting factors in the blood. Excessive and Rapid loss of blood can cause a major drop in the blood pressure of the mother, leading to shock and death if not treated.
What is Postpartum Hemorrhage?
Risk Factors of Postpartum Hemorrhage
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Placental Abruption: The early detachment of the placenta from the uterus
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Over Distended Uterus: When the uterus is larger than normal because of too much amniotic fluid or a large baby
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Multiple-Baby Pregnancy: Twins, triplets, etc. or having many previous births
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High Blood Pressure Disorders of Pregnancies
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Prolonged Labor
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Infection
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Obesity
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Asian or Hispanic Ethnic Background
**IT IS IMPORTANT TO KNOW BEFORE DELIVERY THE RISK FACTORS OF PPH AS EARLY CARE CAN
​ REDUCE THE AMOUNT OF BLOOD LOSS
What are the Symptoms of Postpartum Hemorrhage?
Symptoms of PPH vary from person to person, but the most common symptoms are as follow:
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Uncontrolled Bleeding
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Decreased Blood Pressure
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Increased Heart Rate
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Decreased Red Blood Cell Count
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Swelling and Pain in Tissues in the Vaginal Area
How is Postpartum Hemorrhage Treated?
of these these deaths were in developing countries
The goal for the treatment of PPH is to find the cause of bleeding and stop the bleed as soon as possible. Treatment options include:
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Certain medicine (Pitocin, Hemabate, Methergine, and Cytotec) or uterine massages to stimulate uterus contractions
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Removing pieces of the placenta that remain in the uterus
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Bakri Balloon to put pressure on the bleeding inside the uterus
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Laparotomy: opening the abdomen to find the source of bleeding
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Tying off/sealing blood vessels
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Hysterectomy: complete removal of the uterus (last resort)
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KEY POINTS TO KNOW: STATISTICS ABOUT PPH
14M
women suffer from PPH around the world every year.
An estimated
100,000
women died from PPH in 2015.
99%
2.9%
of women in the U.S. will hemorrhage.
​REFERENCES
Children's Hospital. “Postpartum Hemorrhage.” Children's Hospital of Philadelphia, The Children's Hospital of Philadelphia, 24 Aug. 2014, https://www.chop.edu/conditions-diseases/postpartum-hemorrhage.
“Default - Stanford Children's Health.” Stanford Children's Health - Lucile Packard Children's Hospital Stanford, https://www.stanfordchildrens.org/en/topic/default?id=postpartum-hemorrhage-90-P02486.