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Melanie Shoemaker

11/28/16

NUR 176

Postpartum Hemorrhage

Postpartum hemorrhage, or after birth bleeding, is excessive or very heavy bleeding after

childbirth. Postpartum hemorrhage is the leading cause of maternal death and all women who

carry a pregnancy beyond 20 weeks are at risk for experiencing postpartum hemorrhage. (1)

Postpartum hemorrhage is more likely with a cesarean birth (C-section) and may occur before

or after the placenta is delivered. (2) Once a baby is delivered, the uterus normally contracts

and pushes out the placenta. After the placenta is delivered, these contractions help put

pressure on the bleeding vessels in the area where the placenta was attached to the uterine

wall. If the uterus doesn’t contract strongly enough, the blood vessels bleed freely. Small pieces

of the placenta may also stay attached and will cause bleeding. (3)

Common signs and symptoms of postpartum hemorrhage are bleeding from the vagina that

does not slow or stop, drop in blood pressure, signs of shock, blurry vision, chills, clammy skin,

very fast heartbeat, feeling confused or dizzy, sleepy or weak, feeling like you are going to faint,

nausea and vomiting, pale skin, and swelling and pain around the vagina or perineum (the area

between the vagina and rectum). (4) There are also common conditions or risks that could lead

to postpartum hemorrhage such as, having a history of postpartum hemorrhage. Uterine atony,

which is when your uterus doesn’t contract well after birth, uterine inversion, which is when

the uterus turns inside out after birth, placental problems, and uterine rupture, which is when
the uterus tears during labor; all lead to postpartum hemorrhage. Having a C-section, receiving

general anesthesia, taking medications to induce labor such as Pitocin, tearing, obesity,

gestational hypertension, and certain blood conditions such as disseminated intravascular

coagulation; also all increase your risk of postpartum hemorrhage. (4)

Treatment for postpartum hemorrhage includes blood tests to test clotting factors in the

blood, testing hematocrit levels which checks the percent of blood that is made up of red blood

cells, and measuring blood loss. A pelvic exam, physical exam (blood pressure and pulse), and

an ultrasound are also performed. You may also receive IV fluids, medications such as Pitocin, a

blood transfusion, having surgery, such as a hysterectomy (removal of the uterus) or

laparotomy (stoppage of bleeding by opening up the abdomen and finding and stopping the

source of bleeding), massaging of the uterus to induce contraction, receiving oxygen via face

mask, removal of remaining pieces of the placenta from the uterus, and embolization (clotting)

of the blood vessels that supply the uterus. (4)


Work Cited

1. Postpartum Hemorrhage. (n.d.). Retrieved December 04, 2016, from

http://emedicine.medscape.com/article/275038-overview

2. http://www.chw.org/medical-care/fetal-concerns-center/conditions/pregnancy-

complications/postpartum-hemorrhage

3. Postpartum hemorrhage - health encyclopedia - university of Rochester medical center.

(2016). Retrieved December 4, 2016, from

https://www.urmc.rochester.edu/Encyclopedia/Content.aspx?ContentTypeID=90&ContentID=P

02486

4. Postpartum hemorrhage. (2016). Retrieved December 5, 2016, from

http://www.marchofdimes.org/pregnancy/postpartum-hemorrhage.aspx