Postpartum Hemorrhage Research Paper

Postpartum hemorrhage is excessive blood loss after childbirth. Some blood loss is normal after delivering a baby. However, postpartum hemorrhage is a potentially serious condition.

CAUSES

A loss of muscle tone in the uterus after childbirth.

Failure to deliver all of the placenta.

Wounds in the birth canal caused by delivery of the fetus.

A maternal bleeding disorder that prevents blood clotting (rare).

RISK FACTORS

You are at greater risk for postpartum hemorrhage if you:

Have a history of postpartum hemorrhage.

Have delivered more than one baby.

Had preeclampsia or eclampsia.

Had problems with the placenta.

Had complications during your labor or delivery.

Are obese.

Are Asian or Hispanic.

SIGNS AND SYMPTOMS

Vaginal bleeding after delivery is normal and should be expected. Bleeding (lochia) will occur for several days after childbirth. This can be expected with normal vaginal deliveries and cesarean deliveries.

You are bleeding too much after your delivery if you are:
Passing large clots or pieces of tissue.

This may be small pieces of placenta left after delivery.

Soaking more than one sanitary pad per hour for several hours.

Having heavy, bright-red bleeding that occurs 4 days or more after delivery.

Having a discharge that has a bad smell or if you begin to run an unexplained fever.

Having times of lightheadedness or fainting, feeling short of breath, or having your heart beat fast with very little activity.

DIAGNOSIS

A diagnosis is based on your symptoms and a physical exam of your perineum, vagina, cervix, and uterus. Diagnostic tests may include:

Blood pressure and pulse.

Blood tests.

Blood clotting tests.

Ultrasonography.

TREATMENT

Treatment is based on the severity of bleeding and may

include:
Uterine massage.
Medicines.
Blood transfusions.
Sometimes bleeding occurs if portions of the placenta are left behind in the uterus after delivery. If this happens, often a curettage or scraping of the inside of the uterus must be done. This usually stops the bleeding. If this treatment does not stop the bleeding, surgery (hysterectomy) may have to be performed to remove the uterus.
If bleeding is due to clotting or bleeding problems that are not related to the pregnancy, other treatments may be needed.
HOME CARE INSTRUCTIONS

Limit your activity as directed by your health care provider. Your health care provider may order bed rest (getting up to the bathroom only) or may allow you to continue light activity.
Keep track of the number of pads you use each day and how soaked (saturated) they are. Write this number down.
Do not use tampons. Do not douche or have sexual intercourse until approved by your health care provider.
Drink enough fluids to keep your urine clear or pale yellow.
Get proper amounts of rest.
Eat foods that are rich in iron, such as spinach, red meat, and legumes.
SEEK IMMEDIATE MEDICAL CARE IF:

You experience severe cramps in your stomach, back, or belly (abdomen).
You have a fever.
You pass large clots or tissue. Save any tissue for your health care provider to look at.
Your bleeding increases.
You become weak or lightheaded, or you pass out.
Your sanitary pad count per hour is increasing.