Postpartum Hemorrhage

(Obstetric Hemorrhage)

Definition

Postpartum hemorrhage is excessive blood loss in a woman after childbirth. It is called primary when it is within the first 24 hours after childbirth. Secondary (or delayed) postpartum hemorrhage occurs between 24 hours to six weeks after childbirth.Some blood loss is normal. However, postpartum hemorrhage is a potentially serious condition that often goes unrecognized. Any excessive blood loss can put a woman at considerable risk. Talk with your doctor if you have any concerns about blood loss after giving birth.
Postpartum Hemorrhage
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Copyright © Nucleus Medical Media, Inc.

Causes

Postpartum hemorrhage can be caused by:
  • A loss of muscle tone in the uterus after birth
  • Wounds in the birth canal
  • Failure to deliver the placenta
  • Maternal bleeding disorders that prevent blood clotting (rare)
In rare cases, uterine inversion or uterine rupture may also cause postpartum hemorrhage.

Risk Factors

Postpartum hemorrhage may be more common in Asian and Hispanic women.Factors leading up to labor that may increase your chance of postpartum hemorrhage include:
  • History of previous postpartum hemorrhage
  • Pre-eclampsia
  • Problems with the placenta
  • Obesity
  • First pregnancy
  • Multiple pregnancy, which may create high amniotic fluid levels
Complications of labor and delivery that may increase your chance of postpartum hemorrhage include:
  • Interventions, such as:
    • Augmented labor—methods that stimulate or speed the progression of labor when it is delayed or stopped
    • Forceps or vacuum delivery
    • Episiotomy
    • Cesarean section
  • Prolonged labor
  • Large fetus
  • Chorioamnionitis—a bacteria infection of the membranes and fluid surrounding the fetus
  • Stillbirth
Demonstration of Forceps and Vacuum Delivery
Vacuum and forceps delivery
Copyright © Nucleus Medical Media, Inc.

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