Becoming a mother is a task that involves crossing many obstacles. Giving birth to a child is not easy as there are many complications associated with childbirth. Even if you have delivered safely, there are other postpartum problems that a mother may experience. Postpartum hemorrhage is a serious and uncommon condition that only a few women experience but this is a life-threatening situation that may risk the life of the mother. Very few women know about this condition whereas every aspiring mother must know about PPH. Onlymyhealth reached out to Dr. Ruchi Srivastava, Professor and Senior Gynaecologist at Sharda Hospital, Greater Noida to understand more about Postpartum hemorrhage, why it is caused and how it can be prevented.
What is Postpartum Hemorrhage?
Postpartum hemorrhage (also called PPH) is said to occur when a woman has heavy bleeding after giving birth and the estimated blood loss is 500 ml or more. It's a serious and uncommon condition. It usually happens within 1 day of giving birth, but it can happen up to 12 weeks after having a baby. This is why Postpartum hemorrhage can be divided into 2 types:
- Early postpartum hemorrhage, which occurs within 24 hours of delivery, and
- Late postpartum hemorrhage, which occurs 24 hours to 6 weeks after delivery.
Most cases of postpartum hemorrhage, greater than 99%, are early postpartum hemorrhage. It is the leading cause of maternal mortality in developing countries like ours.
Pic courtesy- Lopez McHugh
What Causes Postpartum Hemorrhage?
When the uterus fails to contract after delivery of the baby is one of the most common causes of postpartum hemorrhage and is termed as ‘atonic PPH’. Uterine contractions after birth help stop bleeding from the place in the uterus where the placenta breaks away.
PPH is mainly caused by:
- Placental abruption (The early detachment of the placenta from the uterus)
- Placenta previa(The placenta covers or is near the cervical opening)
- Overdistended uterus
- Excessive amount of liquor
- Multiple pregnancy
- Gestational hypertension or preeclampsia
- Having many previous births
- Prolonged labor
The reason why PPH is a concern is because the uncontrolled and rapid blood loss in this condition can result in low blood pressure. This can leave the mother in shock and if not treated timely, it can even lead to death. Immediate and experienced medical intervention is very crucial in such cases.
Symptoms of postpartum hemorrhage
While early postpartum hemorrhage can be easily identified by the doctors who are supervising you during the delivery, late PPH which occurs days or maybe weeks later requires attention. Every woman should know of these symptoms of PPH that can help in receiving timely treatment and save the mother’s life. Symptoms may include:
- Uncontrolled bleeding
- Increased heart rate
- Sudden drop in blood pressure
- Swelling and pain around the vagina and perineal area
How can postpartum hemorrhage be treated and prevented?
Most deaths resulting from PPH occur during the first 24 hours after birth and majority of these could be avoided by timely and appropriate management. WHO has recommended various techniques to prevent PPH which doctors routinely follow in all their delivery patients with good results. In last 2-3 years newer and novel techniques have also been developed to prevent this disastrous condition.
The treatment options for Postpartum Hemorrhage include:
- Medications to control contractions in the uterus
- Massaging the uterus manually to stimulate uterine contractions
- Medical examination of pelvic tissues and uterus
- Removing placental pieces from the uterus surgically
- Compressing the bleeding area in the uterus using sterile materials and sponges
- Laparotomy surgery which involves opening of the abdomen
- Hysterectomy- removing the uterus through surgery(which is the last solution to manage the condition and save mother’s life)
Though postpartum hemorrhage is a deadly condition but the good thing is that it can be prevented if managed appropriately by an experienced gynaecologist. Women should learn about this fatal condition before heading for delivery and be prepared. Watching out symptoms of PPH after delivery is also necessary.
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