Postpartum hemorrhage refers to excessive bleeding of the mother after the delivery of the baby. Only 4 per cent women get affected by the postpartum hemorrhage. Postpartum hemorrhage is usually followed after cesarean birth. Though most of the postpartum hemorrhage takes place right after delivery yet it can also be expected in the later phases. It is quite obvious that the amount of blood loss is more in case of cesarean birth than vaginal delivery and so, the risk of postpartum hemorrhage is also high in case of cesarean birth. Hemorrhage can occur at any time, either before or after the placenta is released.
The uterus normally starts contracting after delivery and the tightening of uterine muscles expels the placenta. After the placenta is delivered, these contractions help to compress the bleeding vessels of the area where the placenta was attached. But, if the uterus does not contract properly, then, it can lead to uterine atony. Uterine atony again results in free bleeding of blood vessels and hemorrhage and this is how postpartum hemorrhage occurs. If small pieces of placenta remain attached to the uterus even after delivery, then, there is a chance of postpartum hemorrhage and bleeding. Let us take a look at the factors which might increase the risk of postpartum hemorrhage:
placenta abruption
multiple pregnancy
pregnancy induced hypertension
prolonged labor
obesity
infection
placenta previa
abnormal enlargement of the uterus
general anesthesia
forceps delivery
stop contraction medications
medications to induce labor
tear in vaginal tissues or cervix
blood clotting disorders like intravascular coagulation
placenta percreta
placenta accreta
placenta increta
symptoms of postpartum hemorrhage:
decreased blood pressure
uncontrolled bleeding
swelling and pain in vaginal or perineal tissues
increased heart rate
decrease in hematocrit or red blood cell
Proper medication for stimulating uterine contractions, tying off bleeding blood vessels, proper examination of uterus and pelvic tissues, manual massage of uterus, removal of the residual placenta pieces, laparotomy and hysterectomy or surgical removal of the uterus can control postpartum hemorrhage.
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But, surgical removal of the uterus is the last option one would go for, especially, after first delivery. One can also pack the uterus with sponges and sterile materials to check the uncontrolled bleeding.
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