Is my life threatened by excessive postpartum uterine bleeding?

(March 24, 2010)

Excessive bleeding from the uterus, or post partum hemorrhage refers to the loss of over 1 pint of blood, immediately after a vaginal delivery or over 2 pints of blood after a cesarean. Excessive bleeding from the uterus is a cause for major concern. Generally, a woman loses about one pint of blood after a normal delivery. This happens because some blood vessels are opened with the placenta is detached from the uterus. The contractions of the uterus help to close the vessels, until they can heal.

However, if a woman loses more than one pint of blood when the placenta is delivered, it is considered as excessive bleeding. This severe loss in blood usually occurs immediately after deliver. However, it can also occur as late as a month later. This condition can occur, when the contractions of the uterus are impaired. In that case the open blood vessels may continue to bleed.

The contractions of the uterus may be impaired by any of the following reasons:

•    When the uterus has stretched too much, maybe because of excessive amniotic fluid, or multiple babies or even a very large baby
•    In case a woman has delivered over five babies
•    When some placenta remains inside the uterus after delivery
•    In case a muscle-relaxing anesthetic was used

Excessive bleeding need not result only from impaired uterine contractions. It can also be caused by other factors. When the vagina or the cervix gets cut or torn, during delivery. Excessive bleeding may also be the result of lower levels of fibrinogen in the blood. This is because fibrinogen helps the blood to clot. This could also be caused by a ruptured uterus. A bleeding disorder which hinders clotting could cause excessive bleeding.
 
Excessive uterine postpartum bleeding can be a life-threatening situation and its morbidity is related to the effects of blood loss as well as the potential complications of hemostatic and resuscitative interventions.

Postpartum hemorrhage occurs in 1 out of every 5 pregnancies. But this figure may differ, based on the different definitions of “postpartum hemorrhage”. It is accountable for approximately 8% of the maternal deaths in developed countries. Nevertheless, it is one of the leading causes of maternal mortality.

As excessive bleeding is a major concern, most doctors try to prevent it, or prepare for it, before a woman goes into labor. First, they check if the woman has any condition that can increase the risk of bleeding. If the woman’s blood type is unusual, doctors will ensure that her blood type is available. Then, they try to ensure that the delivery is as gentle as possible. Finally, after delivery, a woman is monitored for a while, to make sure that the uterus has contracted and that there is no excess bleeding.

Submitted by P T on March 24, 2010 at 12:03

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