Pregnancy / Childbirth

Postpartum hemorrhage, bleeding after delivery - when you lose too much blood ...


Postpartum hemorrhage (PPH) is a life threatening condition. This is one of most serious labor complications. The more dangerous that his occurrence can only be predicted 40% of all women who will face this problem. In addition, postpartum bleeding often occurs unpredictably and poses a great challenge to healthcare professionals.

Postpartum hemorrhage occurs in 5% of all women giving birth. How to recognize him? When does postnatal physiological blood loss occur due to uterine cleansing, and when is the blood loss too high?

When is bleeding after delivery normal?

After each delivery, both natural and completed Caesarean section, there is bleeding that allows the uterus to be removed and the reproductive organs cleansed. It is a physiological process accompanied by contraction of the uterus, its cleansing and healing.

This process usually continues up to 2-4 weeks. There is usually less discharge each day after delivery. Its color also changes: from vivid red to brown and ending in pale yellow.

When are we talking about postpartum hemorrhage?

We are talking about postpartum hemorrhage in a situation when the uterus does not contract properly after delivery (uterine atony occurs). The immediate cause can be infections, placental remnants in the uterus, and vulvar or vaginal wounds.

Postpartum hemorrhage occurs when:

  • after a natural delivery you lose more than 500 ml of blood a day,
  • after surgery, you lose more than 1000 ml of blood a day.

The most common factors that increase the risk of excessive blood loss after delivery are:

  • giving birth to a large child (excessively enlarged uterus)
  • long, tiring labor
  • placenta placenta
  • uterine fibroids
  • induced delivery
  • premature detachment of the placenta
  • pregnancy-induced hypertension
  • multiple pregnancy
  • hydramnion
  • mother's mature age,
  • mother's high BMI,
  • smoking,
  • cesarean section,
  • genetic causes.

A single bleeding transition increases the risk of a problem in subsequent pregnancies. The risk of postpartum hemorrhage increases in women giving birth by Caesarean section.

When does postpartum hemorrhage occur and how does it manifest itself?

Postpartum hemorrhage usually occurs on day 1 (primary postpartum hemorrhage) or on the second day after delivery, and later up to 6 weeks after delivery (secondary postpartum hemorrhage).

When the hemorrhage occurs up to 24 hours after delivery, we are talking about early bleeding, if later - late bleeding.

Postpartum hemorrhage is recognized after increased blood loss, the presence of many blood clots, malaise, as well as increased heartbeat and low blood pressure. Chills, shortness of breath, paleness of the skin, visual disturbances and even loss of consciousness may occur.

Oxytocin administration during the third period of delivery reduces the risk of postpartum hemorrhage. It also has a very important preventive effect breastfeeding, which helps the process of contracting the uterus after delivery.

How is postpartum hemorrhage treated?

In the case of postpartum hemorrhage, which is life threatening, hospitalization is necessary. A doctor dealing with excessive bleeding performs external uterine massage, abdominal aortic pressure, Hamilton grip (two-handed uterus grip), uterine decongestants are also given. If these methods do not give the expected effect, it becomes necessary surgery to stop bleeding. In extreme cases, it is necessary to resect the uterus.

Despite the progress of medicine, excessive bleeding is the most common cause of death after delivery. Unfortunately, women who have postpartum haemorrhage after Caesarean section have a lower chance of getting pregnant again. Scientists did not notice such a relationship for natural births.

After hemorrhage, apply a diet high in protein, vitamin C and iron.