Postpartum hemorrhage is excessive blood loss in the mother. It is called primary when it is within the first 24 hours after childbirth. Any excessive blood loss can put the mother at considerable risk. The blood loss is usually shortly after delivery.
Secondary 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. Talk with your doctor if you have any concerns about blood loss after giving birth.
The following are potential causes of postpartum hemorrhage:
The following factors are thought to increase the risk of postpartum hemorrhage:
The most obvious sign is heavy vaginal bleeding during the first 24 hours after childbirth. If the bleeding is not obvious, other signs may include:
Your doctor will ask about your symptoms. A physical exam will be done. The doctor will check your perineum, vagina, cervix, and uterus for bleeding. Other tests may include:
Talk with your doctor about the best plan for you. Treatment options include:
You may need:
A massage technique called bimanual uterine massage can control bleeding. A doctor or nurse will place one hand in your vagina to push on your uterus, while the other hand pushes down on your abdomen. This action will cause a relaxed uterus to contract, thus slowing bleeding.
Bleeding can be caused by a tear in your genital tract or other trauma. The tear will be sutured. In addition, tissue from a retained placenta may need to be removed.
Your doctor may prescribe medications to contract the uterus. Examples include:
In some cases, surgery may be needed, such as:
These methods may reduce the risk of postpartum hemorrhage:
RESOURCES:
American Congress of Obstetricians and Gynecologists
http://www.acog.org/
American Pregnancy Association
http://www.americanpregnancy.org/
CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca/index_e.html/
Women's Health Matters
http://www.womenshealthmatters.ca/index.cfm/
References:
American College of Obstetricians and Gynecologists. Postpartum hemorrhage. In: ACOG Practice Bulletin 76. October 2006.
Postpartum hemorrhage. DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Accessed June 25, 2007.
Postpartum hemorrhage. University of Virginia Health System website. Available at: http://www.healthsystem.virginia.edu/uvahealth/peds_hrpregnant/postpart.cfm . Accessed June 25, 2007.
Last reviewed February 2010 by Ganson Purcell Jr., MD, FACOG, FACPE
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.