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Postpartum Hemorrhage

Description

When a woman loses too much blood (more than 500-1000ml) after giving birth, it is termed postpartum hemorrhage. It is a common reason behind maternal deaths.

Causes

Most cases are seen after a cesarean section. However, sometimes vaginal delivery also leads to postpartum blood loss. Some common causes are:

  •  With lack of uterus’ contraction after delivery of baby and placenta, the bleeding continues.
  • Getting an infection due to contaminated equipment.
  • A placenta tissue that is not removed entirely.
  • Injury to uterus by use of forceps or vacuum to assist delivery.
  • Medicines taken to induce labor.
Risk factors

With too much blood loss, there is a chance of low blood volume and low blood pressure. Sometimes, the uncontrolled drop in body fluid and blood results in shock (organs shut down) and death.

 The risk of hemorrhage is more if:

  • The woman is having a bleeding disorder (problem with blood clotting)
  • Pregnancy-related hypertension
  • The birth weight of child is too much.
  • An extended labor time.
  • Multiple births like twins or triplets.
  • A large incision given in vagina to ease the delivery can also cause continued bleeding.
Symptoms

As the bleeding continues, these signs start to appear:

  •  Low blood pressure.
  • Pulse rate increases.
  • Abdominal pain and cramps.
  • Nausea and vomiting.
  • With the ongoing bleeding, blood cells count decreases.
  • Weakness and inability to stand unassisted.
Diagnosis

Blood loss is the first marker of postpartum hemorrhage and the loss of blood is measured by a collection bag or number of pads changed after delivery.

In addition, a doctor is going to check the vitals (blood pressure, pulse rate, breathing) and take a blood sample to test for drop in blood count and hemoglobin level.

Management

The treatment options are taken according to the cause for blood loss.

  • Remaining Placental tissue is taken out through scraping.
  • Trauma to uterus is managed with stitches in lower part and placing cellulose sponges to absorb bleeding.
  • Oxytocin injection is given to help uterus contraction and control bleeding.
  • Blood transfusion to retain blood loss and maintain fluid levels.
When to consult a doctor?

Seeing your gynecologist throughout pregnancy will help keep your condition monitored and prepare beforehand for any risk factors like a bleeding problem, previous delivery with too much blood loss, unusual blood type or any complication in pregnancy.

Available Medicine for Postpartum Hemorrhage

Methergine 0.2mg

Rs.6

Novartis

Methergine 0.125mg

Rs.22.5

Novartis

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