What is postpartum hemorrhage?


Postpartum hemorrhage is when a woman bleeds excessively after giving birth. It is an emergency that can be life-threatening for both mother and baby.

Postpartum hemorrhage (PPH) is the loss of more than 500 milliliters of blood within 24 hours following delivery.

Postpartum hemorrhage occurs when the uterus fails to contract normally to control heavy bleeding after childbirth. As a result, this can lead to a significant loss of blood volume which can result in organ failure and death if left untreated. If any signs and symptoms are detected, it is imperative that medical attention be sought without delay:

  • Considerable vaginal bleeding after delivery
  • Heavy vaginal bleeding
  • Severe abdominal pain
  • Rapid heart rate
  • Dizziness or fainting
  • Fever

The postpartum hemorrhage is fatal for one out of five pregnancies in the world and it is important for any woman who has delivered a baby to know about it, as well as how to prevent it from happening again at their next pregnancy.

What causes postpartum hemorrhage?

Postpartum hemorrhage, or excessive bleeding after childbirth, can be caused by many factors. It could be related to the placenta or uterus. Sometimes the placental tissues calcify and the uterus doesn’t contract in order to expel it properly. Postpartum hemorrhage can also be due to an infection, such as endometritis, that leads to an increased blood flow from the uterus into other parts of the body. There are many different causes of postpartum hemorrhage and unfortunately, not all are treatable.

The following causes may contribute:

  • The placenta has not been expelled properly
  • Infection
  • Hormone imbalance
  • Uterine inversion
  • Laceration of the uterus or cervix
  • Prolonged heavy vaginal bleeding
  • Uterine atony

What are the reasons behind postpartum hemorrhage?

Some of the reasons why this may happen are:

  • The uterus contracts too much after delivery.
  • Infection during pregnancy or the postpartum period can cause heavy bleeding.
  • Lack of or failure to recognize vaginal blood loss for a prolonged period before childbirth, which is not uncommon in developing countries and parts of Africa.
  • A tear in the uterine wall (uterine atony) from a difficult birth, whether from an assisted vaginal delivery or caesarean section.

Who is at risk for postpartum hemorrhage?

Postpartum hemorrhage can affect anyone who gives birth vaginally, but there are some risk factors that make you more likely to experience this condition. Conditions that may increase the risk include:

  • Prior uterine surgery
  • Placenta abruption
  • Multiple births (twins, triplets)
  • Epidural anesthesia
  • Obesity
  • High blood pressure disorders of pregnancy
  • Having many previous births

How is postpartum hemorrhage diagnosed?

Postpartum hemorrhage is a major cause of maternal mortality. It is estimated that one out of every six pregnant woman experiences postpartum hemorrhage, and the condition can lead to death in 1-2% of pregnant women.

Postpartum hemorrhage is diagnosed through visual and physical examinations, lab tests, and a thorough review of your medical history.

The following methods can also be used to diagnose PPH:

  • We monitor your pulse rate and blood pressure constantly to detect problems.
  • Take Measurement of red blood cells (hematocrit) and clotting factors in the blood.
  • A detailed ultrasound image of the uterus and other organs is obtained using ultrasound.

How we treat postpartum hemorrhage in Gurgaon?

Postpartum hemorrhage is a rare but serious complication during the last stage of childbirth. Fortunately, doctors have different treatment options that depend on the severity of the condition when a postpartum hemorrhage occurs.

Severity is what determines the best course of treatment for postpartum hemorrhage. The more severe it is, the more invasive and destructive measures doctors will take to stop it.

  • Laparotomy : Doctors might need to perform a laparotomy to suture up any bleeding vessels in the abdomen.
  • Hysterectomy : A hysterectomy may also be needed to control heavy bleeding with the removal of uterus and cervix in order to save a woman's life.
  • In some cases, an external fixator device may be needed to control bleeding from pelvic fractures or other injuries in nearby organs such as kidneys or bladder.

There are other several treatments used, including:

  • Your uterus muscles will contract with uterine massage.
  • Contractions are stimulated by medication.
  • Removing retained placental tissue from the uterus.

How can I prevent hemorrhaging during childbirth?

When a woman is going into labor, the uterus contracts and pushes the baby through the birth canal. Hemorrhaging occurs when some of the membrane or placenta (afterbirth) is left inside the woman after giving birth.

The following might provide some help:

  • We at, Dr. Astha Dayal Clinic, Obstetrician should examine all vaginal bleeding to identify if any tissue remains in the birth canal.
  • If there is evidence of hemorrhaging, we will conduct a manual examination to determine if there are any remaining pieces and remove them.
  • After that, they may need to apply pressure on incision sites to stop bleeding and use surgical instruments such as forceps, scissors and clamps.

A note from Dr. Astha Dayal Clinic:

We are concerned about the fact that so many women these days have to leave their newborns and go through postpartum hemorrhage even after a normal vaginal delivery. This is because there is often bleeding which occurs too much or excessive bleeding from the uterus after the baby is delivered.

It could be due to uterine atony, uterine rupture, placental abnormalities, eclampsia etc. If we treat this correctly it will not only help the woman but also her baby and future pregnancies.

Dr. Astha Dayal Clinic is known for providing high-quality obstetric care, ensuring timely and precise diagnosis, and utmost attention to detail.

Dr. Astha Dayal is an expert in treating many obstetric emergencies such as postpartum hemorrhage, placenta previa, gestational hypertension, pre-eclampsia etc.

This note from Dr. Astha Dayal Clinic is intended to provide a brief overview of the clinic's services and highlight their expertise in managing some of the most common obstetric emergencies that arise during pregnancy such as postpartum hemorrhage, placenta previa, gestational hypertension, pre-eclampsia etc.,

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