Leyna Bristoll

Postpartum hemorrhage can be defined as when a women is heavily bleeding after giving birth.

Specifically a blood loss of 500mls of blood after birth, not to be confused with the 500mls during vaginal

deliver or the 1000mls from a cesarean section that is within normal limits. This is one of the leading

causing in morbidity in laboring women, especially in third world countries. The deaths usually occur in

the first 24 hours after birth if the bleeding isn't stopped. Unfortunately, this life threatening condition can

be caused by many things including: vaginal or cervical lacerations, uterine rupture, blood clotting

disorders, a uterus that stays softened, maternal clotting disorders, and retained placental tissue ("WHO

recommendations for the prevention and treatment of postpartum hemorrhage"). Symptoms for

this are decreased blood pressure, increased heart rate, uncontrolled bleeding, anemia, swelling and pain

in the vaginal and perineal area. This condition can be diagnosed by a blood sample to get an accurate

estimate of hematocrit and clotting factors, observing vitals, and estimating the blood loss by observing

saturated pads ("Postpartum hemorrhage").

Treatment is focused on stopping the bleeding usually through injectable drugs such as oxytocin

which helps the uterus contract to constrict the blood vessels which in turn stop the bleeding. The uterus

gets relaxed, drops down and softens (vasodilates) during delivery to help get the baby out, which also

increases bleeding. Normally the uterus will contract back up by the umbilicus on it's own and is checked

post delivery by feeling the "firmness" of the fundus (upper part of the uterus) to make sure it is

contracting. If the fundus doesn't feel "firm" then the nurse gently massages in a circular pattern to help

stimulate the uterus to do this on its own. If checked again and the uterus still feels soft, further

intervention is required through drug therapy. In some instances of vaginal or cervical trauma

causing the bleeding, surgery might be the next option. This condition is manageable and mostly

preventable by having trained staff present during the third stage of labor to recognize symptoms
and begin treatment ("WHO recommendations for the prevention and treatment of postpartum

haemorrhage").
 Works cited

Postpartum hemorrhage. (n.d.). Retrieved April 01, 2017, from http://www.chw.org/medical-

care/fetal-concerns-center/conditions/pregnancy-complications/postpartum-hemorrhage/

WHO recommendations for the prevention and treatment of postpartum haemorrhage. (n.d.).

Retrieved April 01, 2017, from

http://apps.who.int/iris/bitstream/10665/75411/1/9789241548502_eng.pdf