Written by : Dr.M.D.Mazumdar, MD
Postpartum haemorrhage is defined as excessive bleeding occurring at any time from the birth of the baby upto 6 weeks after delivery. The bleeding loss has to be greater than 500 ml of blood following vaginal delivery, or 1000 ml of blood following cesarean section to be labelled as postpartum hemorrhage. This amount is usually sufficient to affect the general condition of the woman.
There are two clinical types of postpartum hemorrhage:
Do you have an Obgyn question? Something you are concerned about?
Consult Dr. Mazumdar - Ask a question and get a reply within 24 hours.
Consultation fees - $20 only through Paypal.
Causes of Atonic Postpartum Hemorrhage are:
Traumatic Haemorrhage : Bleeding can occur from maternal injuries like cervical, vaginal or perineal tears. While minor tears cause only a minimal bleeding which is easily controlled, deep tears may need to be examined and repaired under anesthesia.
Mixed PPH: Postpartum hemorrhage is frequently a mixture of both atonic as well as traumatic hemorrhage. Many of the factors that contribute to the laxity of the uterine muscles are also factors that contribute to injury of the birth canal.
Blood Coagulopathy: Blood coagulopathies like decreased level of platelets in the blood (thrombocytopenia), Factor V Leiden, Von Willebrand's disease are conditions that decrease the ability of the blood to form clots. This can lead to severe hemorrhage.
The main principles of management are:
(a) Prevention of further blood loss.
(b) Restoration of proper blood volume.
(c) Repair of the injured tissues.
(D) Stimulating contraction of the uterine muscles.
Treatment depends on whether the bleeding has occured before the placenta has separated from the uterine wall and been delivered or whether the placenta is still in place inside the uterus (Retained Placenta).
Where the placenta has been delivered but bleeding is still present:
Do you have a gynecological or obstetrical problem? Would you like to discuss it in private? Consult our online gynecologist Dr.M.D.Mazumdar, MD (O&G), at any time you want and get your reply within 24 hours.We charge a nominal fee of USD 20 ($20) per question through Paypal.com.
The procedure of asking a question is quite simple. Clicking on the link below takes you to the Paypal website where the payment is made. After the payment goes through, you will be directed back to this website where you can ask your question. And rest assured, you will get your answer within 24 hours. And usually, even sooner.