WHAT DOES POST PARTUM HEMORRHAGE MEAN?

Bleeding from or into the genital tract following delivery up to the end of the puerperium, which adversely affects the general condition of the mother, is called Post Partum Hemorrhage

WHEN DOES THIS BLEEDING OCCUR?

In the majority it occurs within two hours following delivery. However it can occur anytime upto 6 weeks following delivery.

WHAT CAUSES PPH?

Inadequate contraction power of the uterus (80%)

This is the commonest cause of postpartum hemorrhage. As long as the placenta remains unseparated, bleeding is unlikely. After placenta had separated, the bleeding uterine sinuses, cannot be compressed effectively due to imperfect contraction and retraction of the uterus and bleeding continues.

Following are some of the causes, which often interfere with the retraction of the uterus as a whole and of the placental site in particular.

• More than 4 deliveries in the past
• Over-distension of the uterus: as in cases of twins
• Malnutrition and anemia
• Antepartum hemorrhage
• Prolonged Labor
• Anesthesia
• Malformation of the uterus
• Uterine Fibroid
• Mismanaged third stage of labor
• Injury (20%)
• Combination of above two factors
• Blood clotting defects (rare)

CAN IT BE PREVENTED?

Postpartum hemorrhage cannot always be prevented. However, the incidence and specially its magnitude can be reduced substantially if the following guidelines are followed.

• Check with your doctor about your Hemoglobin levels and follow instructions to maintain a normal level so that you can withstand the blood loss during childbirth.
• Be sure to know your blood group so that no time is lost in case of an emergency.
• Inform your doctor if you have previous history of complications during childbirth or suffered from bleeding during pregnancy.