Aka: Postpartum Hemorrhage. These images are a real-time random sampling from a Google search on the term "Postpartum Hemorrhage. Search Google for all related images. Started in , this collection now contains interlinked topic pages divided into a tree of 31 specialty books and chapters. Content is updated monthly with systematic literature reviews and conferences.
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The most common cause is poor contraction of the uterus following childbirth. Prevention involves decreasing known risk factors including procedures associated with the condition, if possible, and giving the medication oxytocin to stimulate the uterus to contract shortly after the baby is born.
In the developing world about 1. Depending on the source, primary postpartum bleeding is defined as blood loss in excess of ml following vaginal delivery or ml following caesarean section in the first 24 hours following birth. Symptoms generally include heavy bleeding from the vagina that doesn't slow or stop over time. Signs and symptoms of circulatory shock may also include blurry vision, cold and clammy skin, confusion, and feeling sleepy or weak.
Causes of postpartum hemorrhage are uterine atony , trauma , retained placenta or placental abnormalities , and coagulopathy , commonly referred to as the "four Ts": . Other risk factors include obesity , fever during pregnancy, bleeding before delivery, and heart disease. Oxytocin is typically used right after the delivery of the baby to prevent PPH.
Active management of the third stage is a method of shortening the stage between when the baby is born and when the placenta is delivered. Active management involves giving a drug which helps the uterus contract before delivering the placenta by a gentle but sustained pull on the umbilical cord whilst exerting upward pressure on the lower abdomen to support the uterus controlled cord traction.
Another method of active management which is not recommended now is fundal pressure during the delivery of the placenta.
A review into this method found no research and advises controlled cord traction because fundal pressure can cause the mother unnecessary pain. Nipple stimulation and breastfeeding triggers the release of natural oxytocin in the body, therefore it is thought that encouraging the baby to suckle soon after birth may reduce the risk of PPH for the mother.
More research is needed to answer this question. Uterine massage is a simple first line treatment as it helps the uterus to contract to reduce bleeding. Intravenous oxytocin is the drug of choice for postpartum hemorrhage. Oxytocin helps the uterus to contract quickly and the contractions to last for longer.
Syntocinon alone lowers the risk of PPH. Oxytocin requires refrigeration, which may not always be available, particularly in low-resourced settings. Giving oxytocin in a solution of saline into the umbilical vein is a method of administering the drugs directly to the placental bed and uterus. Carbetocin compared with oxytocin produced a reduction in women who needed uterine massage and further uterotonic drugs for women having caesarean sections.
More research is needed to find the cost effectiveness of using carbetocin. Tranexamic acid , a clot stabilizing medication, may also be used to reduce bleeding and blood transfusions in low-risk women,  however evidence as of was not strong. In some countries, such as Japan, methylergometrine and other herbal remedies are given following the delivery of the placenta to prevent severe bleeding more than a day after the birth. However, there is not enough evidence to suggest that these methods are effective.
Surgery may be used if medical management fails or in case of cervical lacerations or tear or uterine rupture. Methods used may include uterine artery ligation, ovarian artery ligation, internal iliac artery ligation, selective arterial embolization, B-lynch suture, and hysterectomy.
When there is bleeding due to uterine rupture a repair can be performed but most of the time a hysterectomy is needed. The World Health Organization recommends the use of a device called the non-pneumatic anti-shock garment NASG for use in delivery activities outside of a hospital setting, the aim being to improve shock in a mother with obstetrical bleeding long enough to reach a hospital. Uterine balloon tamponade can improve postpartum bleeding. Protocols to manage postpartum bleeding are recommended to ensure the rapid giving of blood products when needed.
A Cochrane review suggests that active management use of uterotonic drugs, cord clamping and controlled cord traction during the third stage of labour may reduce severe bleeding and anemia. In the active management group more women returned to hospital with bleeding after discharge, and there was also a reduction in birthweight due to infants having a lower blood volume. The effects on the baby of early cord clamping was discussed in another review which found that delayed cord clamping improved iron stores longer term in the infants.
For preterm babies babies born before 37 weeks a review of the research found that delaying cord clamping may lead to fewer babies with bleeding in the brain, compared to early cord clamping. Another Cochrane review looking at the timing of the giving oxytocin as part of the active management found similar benefits with giving it before or after the expulsion of the placenta.
Methods of measuring blood loss associated with childbirth vary, complicating comparison of prevalence rates. From Wikipedia, the free encyclopedia. Loss of blood following childbirth. Duncow: Sapiens Publishing. Archived from the original on The Lancet. Danforth's obstetrics and gynecology 10th ed. American Society of Hematology. Education Program. World Health Organization. Retrieved American Family Physician. The Cochrane Database of Systematic Reviews.
Geneva: World Health Organization. Monir 7 June The Journal of Reproductive Medicine. American Journal of Obstetrics and Gynecology. International Journal of Fertility and Women's Medicine. Obstetrics and Gynecology Clinics of North America. Philadelphia, Pa: WB Saunders. The Journal of Obstetrics and Gynaecology Research. April Acta Obstetricia et Gynecologica Scandinavica.
February Anesthesia and Analgesia. The Journal of the Pakistan Medical Association. This tool helps". OBG Management. Cochrane Database of Systematic Reviews. Bibcode : PLoSO Pathology of pregnancy , childbirth and the puerperium O , — Acute fatty liver of pregnancy Gestational diabetes Hepatitis E Hyperemesis gravidarum Intrahepatic cholestasis of pregnancy. Gestational pemphigoid Impetigo herpetiformis Intrahepatic cholestasis of pregnancy Linea nigra Prurigo gestationis Pruritic folliculitis of pregnancy Pruritic urticarial papules and plaques of pregnancy PUPPP Striae gravidarum.
Chorea gravidarum. Gestational thrombocytopenia Pregnancy-induced hypercoagulability. Amniotic fluid embolism Cephalopelvic disproportion Dystocia Shoulder dystocia Fetal distress Locked twins Obstetrical bleeding Postpartum Pain management during childbirth placenta Placenta accreta Preterm birth Postmature birth Umbilical cord prolapse Uterine inversion Uterine rupture Vasa praevia.
Breastfeeding difficulties Low milk supply Cracked nipples Breast engorgement Childbirth-related posttraumatic stress disorder Diastasis symphysis pubis Postpartum bleeding Peripartum cardiomyopathy Postpartum depression Postpartum psychosis Postpartum thyroiditis Puerperal fever Puerperal mastitis.
Concomitant conditions Diabetes mellitus Systemic lupus erythematosus Thyroid disorders Maternal death Sexual activity during pregnancy. Categories : Complications of labour and delivery Transfusion medicine.
A non-pneumatic anti-shock garment NASG. Loss of lots of blood after childbirth , increased heart rate , feeling faint upon standing , increased breath rate  . Poor contraction of the uterus , not all the placenta removed , tear of the uterus , poor blood clotting .
Anemia , Asian ethnicity , more than one baby, obesity , age older than 40 years . Oxytocin , misoprostol . Intravenous fluids, non-pneumatic anti-shock garment , blood transfusions , ergotamine , tranexamic acid  . Digestive system Acute fatty liver of pregnancy Gestational diabetes Hepatitis E Hyperemesis gravidarum Intrahepatic cholestasis of pregnancy.
We'd like to understand how you use our websites in order to improve them. Register your interest. The objective of our retrospective study was to estimate the long-term psychological impact of severe postpartum hemorrhage in women whose uterus was preserved. All consecutive women who underwent embolization for postpartum hemorrhage between and and whose uterus was preserved were included. Data were retrieved from medical files and semi-structured telephone interviews.
Impact psychologique à long terme d’une hémorragie sévère du postpartum
The most common cause is poor contraction of the uterus following childbirth. Prevention involves decreasing known risk factors including procedures associated with the condition, if possible, and giving the medication oxytocin to stimulate the uterus to contract shortly after the baby is born. In the developing world about 1. Depending on the source, primary postpartum bleeding is defined as blood loss in excess of ml following vaginal delivery or ml following caesarean section in the first 24 hours following birth. Symptoms generally include heavy bleeding from the vagina that doesn't slow or stop over time. Signs and symptoms of circulatory shock may also include blurry vision, cold and clammy skin, confusion, and feeling sleepy or weak. Causes of postpartum hemorrhage are uterine atony , trauma , retained placenta or placental abnormalities , and coagulopathy , commonly referred to as the "four Ts": .