Postpartum Hemorrhage (PPH) is a potentially fatal condition that happens after childbirth.
When more than 500 mL of blood is lost during vaginal birth or more than 1000 mL is lost during cesarean delivery, this is considered Postpartum haemorrhage.
PPH can strike unexpectedly, resulting in shock or even death if not treated promptly.
Causes of Postpartum Hemorrhage
PPH can be caused by a variety of factors, including:
- Uterine atony
- Retained placenta
- Uterine rupture
- Genital tract trauma
- Coagulopathies
- Placenta accreta
Uterine atony, or the failure of the uterus to contract after delivery, is the most common cause of PPH, accounting for up to 80% of cases.
Treatment of Postpartum Hemorrhage
The management of PPH depends on the cause, severity, and timing of the bleeding.
Initial treatment includes:
- Uterine massage
- Uterotonic medications (such as oxytocin, misoprostol, or carboprost)
- Fluid resuscitation.
If these measures fail, more invasive interventions such as balloon tamponade, uterine artery embolization, or surgery may be necessary.
Prevention of Postpartum Hemorrhage
Prevention of PPH starts with identifying women who are at increased risk of developing this complication, including those with a history of PPH, multiple pregnancies, or a uterine anomaly.
These women may benefit from prophylactic measures such as uterotonic medications, controlled cord traction, and active management of the third stage of labour.
Other strategies to reduce the risk of PPH include early recognition and management of labour dystocia, timely intervention for abnormal placentation, and appropriate management of coagulopathies.
Facts About Postpartum Hemorrhage
- Postpartum haemorrhage is the leading cause of maternal mortality worldwide, accounting for approximately 22% of maternal deaths in Nigeria.
- The incidence of PPH in Nigeria varies widely depending on the population studied and the definition used, but it is estimated to occur in 2-5% of all births.
- Risk factors for PPH include multiple gestations, macrosomia, prolonged labour, and instrumental delivery.
- In addition to maternal morbidity and mortality, PPH can have long-term complications such as anaemia, postpartum depression, and poor bonding with the infant.
- Management of PPH is best handled by a team of medical professionals, including obstetricians, anesthesiologists, haematologists, and other specialists.
In conclusion, postpartum haemorrhage is a life-threatening consequence of delivery that must be diagnosed and treated quickly.
The incidence and severity of PPH can be minimized with adequate preventative measures and prompt care, potentially saving the lives of women and their babies.
