Post-Partum Maternal Hemorrhage (antenatal period)

Post-Partum Hemorrhage (PPH) occurs when a new mother has vaginal bleeding in excess of 500 ml within 24 hours after delivery. Severe PPH occurs when the blood loss exceeds 1,000 ml. When mothers become severely anemic after giving birth, they are at risk for suffering from hypovolemic shock before they have lost 500 ml of blood. Severe bleeding during and after the third stage of labor may be caused by conditions including: uterine atony (failure of the uterus to contract properly after delivery), trauma (cervical, vaginal, or perineal lacerations), retained or adherent placental tissue, clotting disorders, and inverted or ruptured uterus. Post-partum hemorrhage is the most serious complication associated with the third stage of labor (after the baby has been delivered, but before the delivery of the placenta).

What are the Risk Factors of Post-Partum Maternal Hemorrhage?

Uterine atony is a loss of tone in the uterine musculature. When this occurs, the woman’s uterine muscles have lost their ability to contract after childbirth. Some reasons that uterine atony may appear in the mother are an overdistended uterus, labor that fails to progress during the second stage, chorioamnionitis (uterine infection), and the use of pitocin.

How is Post-Partum Maternal Hemorrhage Treated?

The uterus may be stimulated to contract with the use of massage or intravenous oxytocin. Selective angiography (improved visualization of the x-ray study of blood vessels), is a possible interventional treatment method. Emergency surgery may be required if the condition persists. Medical professionals should make preparations if the mother is at risk of uterine atony. This may include medications to induce contractions, having appropriate anesthesia personnel on hand, and having notified the blood bank of a possible need for a transfusion.

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