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Postpartum Period

Postpartum Hemorrhage Symptoms and Treatment

  30 Mar 2013

Explaining postpartum hemorrhage

Postpartum Hemorrhage Symptoms and Treatment Hemorrhage after child birth, also known as postpartum hemorrhage indicates the blood loss measuring more than 500 ml after vaginal delivery and up to 1000 ml blood flow for cesarean section process. Previously mentioned blood loss occurring within the first 24 hour period after child birth is termed as Early postpartum hemorrhage. And the same type of blood loss after the 24 hour time frame is called late postpartum hemorrhage. Late postpartum hemorrhage can happen after days or weeks of the child birth. During the birthing process, it is most common for women to lose a little blood immediately after the placenta gets separated from the uterus. The pregnant body is well equipped to handle the situation since the body gets an almost 50% increase on blood level during pregnancy, unless severe blood loss occurs, which is called postpartum hemorrhage.

Postpartum hemorrhage is one of the leading causes responsible for maternal morbidity and perinatal maternal death worldwide. As soon as the signs of hemorrhage start appearing, treatment measures have to be taken without any delay.

Causes of postpartum hemorrhage

The most common reasons for postpartum hemorrhage are uterine atony, retained placenta, coagulopathy and trauma. Commonly these four causes are nicknamed as the ‘four Ts’.

  • Tone: Uterine atony is the term for the uterus’ inability to contract and that may cause severe continuous bleeding. Infection and Retained placental tissues may be responsible for uterine atony.
  • Trauma: The delivery process trauma may tear tissues and blood vessels, which could lead to postpartum bleeding.
  • Tissue: Retention of tissues from the fetus or the placenta may cause bleeding.
  • Thrombin: It is a bleeding disorder caused by the failure of blood clotting.

Postpartum hemorrhage symptoms

There are a few common signs of hemorrhage. Some of them can be detected quite easily. It is absolutely necessary to respond immediately as the signs of hemorrhage starts showing. Here are the signs of hemorrhage.

  • Heavy vaginal bleeding;
  • Reduced blood pressure;
  • Increased heart rate;
  • Reduced number of red blood cells;
  • Swelling and pain in the vaginal tissues;
  • Swelling and pain around the perineal area.

Risk factors for postpartum hemorrhage

Some mothers face greater danger due to postpartum hemorrhage than the other mothers do. Some risks factors may cause some complications to arise. Some of those causes are stated below.

  • Placental Abruption: The placenta getting detached from the uterus earlier than usual.
  • Placenta Previa: The placenta gets close to or covers the cervical opening.
  • Over distended Uterus: Sometimes excessive amniotic fluid and sometimes a large sized baby stretch the uterus to the highest limit, especially when the baby weight scales more than 8.8 pounds (4,000 grams).
  • Multiple Pregnancies: Multiple placenta and over distention to the uterus.
  • High blood pressure: Induced high blood pressure during the pregnancy period.
  • Others: Among other significant causes there are infections, prolonged labor, obesity, general anesthesia, medicines used to stop contractions, medications used to induce labor, use of forceps, adopting vacuum assisted delivery process, Magnesium Sulfate infusion, Labor augmented with Pitocin etc.

How to prevent postpartum hemorrhage

After child birth all mothers are watched closely for signs of postpartum hemorrhage. There are a few fruitful ways to prevent postpartum hemorrhage. By adopting these steps one can minimize the risks a lot. Here are some stated below.

  • Wait and see: Often doctors just wait and look for the symptoms.
  • Breast feeding: Doctors recommend the mothers to start breast feeding right after the child birth. Breast feeding helps to create her own body Oxytocin which helps the uterus to contract better and faster and the placenta to expel.
  • Massaging: Massaging the uterus also prompts the blood clots to expel.
  • Empty the bladder: By simply emptying your bladder you can reduce the risks by more than half.

Postpartum hemorrhage treatment options

There are a few treatment measures the medical team will adopt immediately if you start bleeding excessively. The whole treatment process goes through a few stages. The treatment options are stated below.

  • As the bleeding starts, the physician will manually massage the uterus to contract better while providing you with intravenous Oxytocin. You’ll be hooked up with an IV.
  • Medications can be applied to stimulate the uterine contractions.
  • Removing the placental pieces if any remains in the uterus.
  • Examining the uterus along with the other pelvic tissues.
  • Use of sterile materials and sponges for compressing the bleeding spots of the uterus.
  • Tying off of the damaged blood vessels.
  • Sometimes doctors go for Laparotomy. Laparotomy is a surgery which includes opening up the abdomen to look for the causes responsible for the bleeding.
  • As the last resort, doctors adopt Hysterectomy. Hysterectomy is a surgery designed to surgically remove the uterus.
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