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Hemorrhage
Hemorrhage
Some women are at greater risk for postpartum hemorrhage than others. Risk factors for postpartum
hemorrhage include the following:
placental abruption - the early detachment of the placenta from the uterus.
overdistended uterus - excessive enlargement of the uterus due to too much amniotic fluid or a large baby,
multiple pregnancy - more than one placenta and overdistention of the uterus.
prolonged labor.
infection.
obesity.
general anesthesia.
Postpartum hemorrhage may also be due to other factors including the following:
bleeding into a concealed tissue area or space in the pelvis which develops into a hematoma, usually in
placenta accreta - the placenta is abnormally attached to the inside of the uterus (a condition that occurs in
one in 2,500 births and is more common if the placenta is attached over a prior cesarean scar).
placenta increta - the placental tissues invade the muscle of the uterus.
placenta percreta - the placental tissues go all the way into the uterine muscle and may break through
(rupture).
Although an uncommon event (one in 2,000 deliveries), uterine rupture can be life threatening for the
mother. Conditions that may increase the risk of uterine rupture include surgery to remove fibroid
(benign) tumors and a prior cesarean scar in the upper part (fundus) of the uterus. It can also occur before
delivery and place the fetus at risk as well.
uncontrolled bleeding
The symptoms of postpartum hemorrhage may resemble other conditions or medical problems. Always
consult your physician for a diagnosis.
estimation of blood loss (this may be done by counting the number of saturated pads, or by weighing of
packs and sponges used to absorb blood; 1 milliliter of blood weighs approximately one gram).
The aim of treatment of postpartum hemorrhage is to find and stop the cause of the bleeding as quickly as
possible. Treatment for postpartum hemorrhage may include:
packing the uterus with sponges and sterile materials (to compress the bleeding area in the uterus).
laparotomy - surgery to open the abdomen to find the cause of the bleeding.
hysterectomy - surgical removal of the uterus; in most cases, this is a last resort.
Replacing lost blood and fluids is important in treating postpartum hemorrhage. Intravenous (IV) fluids,
blood, and blood products may be given rapidly to prevent shock. The mother may also receive oxygen
by mask.
Postpartum hemorrhage can be quite serious. However, quickly detecting and treating the cause of
bleeding can often lead to a full recovery.