Childbirth is a life-changing event when mothers can face significant health challenges, one of the most critical being Postpartum Haemorrhage (PPH). It is defined as excessive bleeding following childbirth and demands a keen understanding of its risks and the effects of substantial blood loss on the mother's health. We spoke to our expert Dr Sowmya Raghavan MBBS, MD, DGO, DNB, Apollo Cradle and Children's Hospital, Chennai, who explained this condition and its risk factors.
Risk Factors For Postpartum Haemorrhage
Various factors contribute to the risk of PPH. Dr Raghavan listed some of them as follows:
Uterine atony: It is the most common cause, where the uterus fails to contract after childbirth leading to continuous bleeding. According to StatPearls, uterine atony is responsible for 70-80% of all haemorrhage.
Other factors include:
- Prolonged labour
- Multiple pregnancies
- Obesity
- Previous history of PPH
- Certain medical conditions like preeclampsia
Additionally, interventions during childbirth, such as caesarean sections or assisted deliveries, increase the risk of excessive bleeding. Not only this, cultural, socioeconomic and geographical factors also play a role.
"Access to quality healthcare, skilled birth attendants and availability of essential medications and blood transfusions greatly impact a woman's risk of experiencing severe PPH", highlighted Dr Raghavan.
Effects of Blood Loss
According to StatPearls, PPH occurs in 1-6% of all deliveries, making it the leading cause of morbidity and mortality in childbirth. Dr Raghavan listed the effects of blood loss as follows:
- The effects of postpartum haemorrhage extend beyond immediate health concerns. Excessive bleeding can rapidly lead to maternal shock, causing a drop in blood pressure and rapid heartbeat.
- Profuse blood loss can result in anaemia, causing fatigue, weakness and organ damage due to decreased oxygen supply in severe cases.
- PPH can lead to emotional distress, impacting the mother's mental health and bonding with the newborn.
Managing and Preventing PPH
Here are some management and preventive measures for PPH as listed by Dr Raghavan:
- Early Recognition: Prompt identification of risk factors and early intervention during labour can mitigate the chances of PPH.
- Active Management of Labour: Active management of the third stage of labour, which includes controlled cord traction and administration of uterotonic medications is crucial in preventing uterine atony.
- Medications: Administration of uterotonics post-delivery can aid in uterine contractions and minimise bleeding.
- Surgical Interventions: In severe cases, surgical procedures like uterine artery ligation or hysterectomy might be necessary to control bleeding.
Support and Recovery
- Medical Follow-up: Close monitoring post-delivery is crucial to ensure the mother's recovery and identify any lingering issues.
- Emotional Support: PPH can be traumatic; hence, emotional support and counselling play a pivotal role in the mother's recovery.
- Nutrition and Rest: Adequate nutrition and rest are essential for replenishing lost blood and aiding recovery.
- Awareness: Empowering women with education about potential risks and the importance of seeking immediate medical attention if they experience any concerning symptoms after childbirth is pivotal.
Bottomline
Dr Raghavan concluded, “PPH remains a critical concern in maternal health that demands proactive measures for prevention, early detection and effective management. Recognising the risks, understanding the effects of blood loss and implementing effective preventive measures and timely interventions are essential in reducing maternal mortality associated with PPH.”
[Disclaimer: This article contains information provided by a registered healthcare professional and is for informational purposes only. Hence, we advise you to consult your expert for a treatment plan suited to your medical history.]