Bradley Hodshire

Carrie Baker-Chizmar

27 March 2017

OB

Postpartum hemorrhage

Postpartum hemorrhage (PPH) is a serious, yet rare, condition that involves an excess

loss of blood after giving birth. Hemorrhaging can occur anywhere from day 1 to 12 weeks after

birth. A few signs, other than the obvious visual loss of blood, would be an increased heart rate,

a decreased blood pressure, nausea and vomiting, pale skin, swelling/pain around the perineum

and if not treated quickly could resort in your organs not getting enough blood flow (shock) and

lead to death. It’s without a doubt there will be blood loss when giving birth to a child,

anywhere from the bloody show to the episiotomy if need. In order to properly call it

hemorrhaging the amount of blood loss is monitored. It is normal for a 500ml blood loss during

a vaginal delivery and 1,000ml blood loss during a C-section.

Increased risks of hemorrhaging that affect the uterus would be a previous PPH, Uterine

atony, Uterine inversion, and Uterine rupture. Asian and Hispanic women for some unknown

reason have a greater risk of PPH as well. Uterine atony is the most common cause of PPH and

its due to the muscles of the uterus not contracting after birth. The contractions after birth

helps to clot where the placenta was attached. The chances for uterine atony are increased

when you have a macro baby, twins, multipara, or a long labor and the uterus is stretched or
enlarged. Uterine inversion is when the placenta fails to separate from the uterus as it leavings

and pulls the uterus inside out. Uterine rupture could happen if you’ve have previous surgery

involving the uterus or a C-section in the past. It occurs when the uterus tears during labor.

A few increased risks of hemorrhaging that affect the placenta would be placental

abruption and placenta previa. Placental abruption is when the uterus detaches from the

uterus before birth. It can be caused by trauma due to a car accident or even just falling.

Placenta previa is when the placenta is attached lower than normal and covers the cervix.

There are a number of exams that can be used to treat PPH. Blood tests to ensure

clotting is well enough, hematocrit levels, blood loss visually by how many pads that have

soaked by a certain amount of time, removing remains of the placenta, getting fluids and

Pitocin to help contractions, and the most famous massaging of the uterus by hand. Nurses are

expected to check the firmness every 15 minutes after birth for an hour and if it is soft they

have to manually massage to ensure this exact thing does not happen.
Work cited:

"Postpartum Hemorrhage." March of Dimes. March of Dimes, Mar. 2015. Web. 27 Mar. 2017.