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How to Treat Postpartum Haemorrhage?

  • January 03, 2024
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How to Treat Postpartum Haemorrhage?

What is Postpartum Hemorrhage (PPH)?

Postpartum hemorrhage (PPH) is a severe bleeding complication occurring within 24 hours to 12 weeks post-childbirth, exceeding 32 fluid ounces of blood loss. Whether from vaginal delivery or Cesarean section, PPH poses a significant risk, demanding immediate intervention. Causes include uterine atony, trauma, retained placental tissue, and coagulation disorders. Recognizing symptoms early, such as changes in heart rate or blood pressure, is crucial for prompt treatment. Interventions range from uterine massage and medications to surgical procedures and blood transfusions. Early detection and intervention are vital to prevent life-threatening consequences, ensuring the well-being of the mother during the critical postpartum period.

Why Does Postpartum Hemorrhage Occur?

Several factors contribute to postpartum hemorrhage, including uterine atony, trauma, retained placental tissue, and coagulation disorders. Uterine atony, the inability of the uterus to contract adequately after childbirth, is the leading cause of PPH. Trauma during delivery, such as tears or lacerations, can also lead to uncontrolled bleeding. Retained placental tissue hinders the normal contraction of the uterus, further exacerbating the risk of hemorrhage.


How to Recognize Postpartum Hemorrhage?

Recognizing the signs of postpartum hemorrhage is crucial for timely intervention. Symptoms include excessive bleeding, a rapid heart rate, low blood pressure, pale skin, and feelings of dizziness or faintness. Monitoring these indicators closely in the postpartum period is essential for identifying and addressing PPH promptly.

Treatment Solutions for Postpartum Hemorrhage:

  1. Uterine Massage: Uterine massage is a fundamental intervention to stimulate uterine contractions and prevent atony. This involves applying gentle pressure to the uterus through the abdominal wall to encourage its contraction. Healthcare providers commonly perform uterine massage to address postpartum hemorrhage caused by uterine atony.
  2. Medications: Administration of medications, such as oxytocin, is a standard approach to manage postpartum hemorrhage. Oxytocin helps in uterine contraction and reduces bleeding. In cases where oxytocin is ineffective, other drugs like misoprostol or ergonovine may be utilized to promote uterine contractions and control hemorrhage.
  3. Uterine Tamponade: Uterine tamponade involves the insertion of balloons or packing materials into the uterus to apply pressure and control bleeding. This method is particularly effective for cases where bleeding persists despite initial interventions. Balloon tamponade devices like the Bakri balloon have proven successful in managing postpartum hemorrhage.
  4. Surgical Interventions: In severe cases of postpartum hemorrhage, surgical interventions may be necessary. This can include procedures like uterine artery ligation, where blood vessels supplying the uterus are tied off to reduce bleeding. In extreme cases, a hysterectomy might be performed as a last resort to stop life-threatening hemorrhage.
  5. Blood Transfusion: If a significant amount of blood is lost during postpartum hemorrhage, blood transfusions may be required to replace the lost volume and restore adequate oxygen-carrying capacity. Close monitoring of the patient's vital signs and laboratory values is essential to determine the need for and effectiveness of blood transfusions.

Benefits of Prompt Postpartum Hemorrhage Treatment:

  1.  Prevention of Severe Complications: Early intervention plays a pivotal role in preventing severe complications. Timely measures such as uterine massage, medication administration, and uterine tamponade can effectively halt excessive bleeding, averting potential consequences like organ failure, shock, and even mortality. The rapid and appropriate treatment addresses the root causes of PPH, ensuring a more favorable outcome for the mother.
  2. Preservation of Fertility: Some treatment approaches for postpartum hemorrhage, particularly uterine-sparing procedures during surgical interventions, prioritize the preservation of fertility. This is especially significant for women who desire future pregnancies, allowing them the opportunity to expand their families without compromising their reproductive health.
  3. Emotional Well-being: Swift and effective treatment of postpartum hemorrhage not only safeguards physical health but also has a positive impact on emotional well-being. Mothers experiencing PPH can be spared from the trauma and distress associated with severe complications. Prompt intervention contributes to a more positive postpartum experience, fostering emotional recovery and resilience.
  4. Reduced Healthcare Costs: Early intervention in postpartum hemorrhage leads to more efficient and cost-effective healthcare delivery. By addressing the issue promptly, the length of hospital stays can be minimized, and the need for additional procedures reduced. This not only benefits the healthcare system but also lessens the financial burden on the affected families.

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