Prevention of Postpartum Hemorrhage
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Postpartum Hemorrhage (PPH) is excessive vaginal bleeding of greater than 500 ml after childbirth. However, even a small amount of blood loss can be life-threatening for anemic women—and the great majority of women in the developing world are anemic. Annually, PPH is a major cause of the more than 500,000 maternal deaths that occur, responsible for approximately 25% of all maternal deaths globally. Nearly 34% of maternal deaths in Africa and more than 30% in Asia are due to PPH. Caused by a variety of conditions, immediate PPH—excessive bleeding directly following childbirth or within the first 24 hours—is the most common type, and 80% of immediate PPH is caused by uterine atony (failure of the uterus to contract properly after delivery). Factors that can contribute to PPH due to uterine atony are high parity, PPH in a previous delivery, a large fetus, multiple fetuses, or excessive amniotic fluid. Other causes include retained placenta, inverted or ruptured uterus, and cervical, vaginal or perineal lacerations. Notably, the majority of PPH cases occur in women without these factors and who otherwise have normal pregnancies and labors. “Secondary” PPH, defined as hemorrhage after the first 24 hours but less than 6 weeks postpartum, can be produced by retained placental fragments and infection.
Prevention of Postpartum HemorrhageEmail this page Printer-friendly version Postpartum Hemorrhage (PPH) is excessive vaginal bleeding of greater than 500 ml after childbirth. However, even a small amount of blood loss can be life-threatening for anemic women—and the great majority of women in the developing world are anemic. Annually, PPH is a major cause of the more than 500,000 maternal deaths that occur, responsible for approximately 25% of all maternal deaths globally. Nearly 34% of maternal deaths in Africa and more than 30% in Asia are due to PPH. Caused by a variety of conditions, immediate PPH—excessive bleeding directly following childbirth or within the first 24 hours—is the most common type, and 80% of immediate PPH is caused by uterine atony (failure of the uterus to contract properly after delivery). Factors that can contribute to PPH due to uterine atony are high parity, PPH in a previous delivery, a large fetus, multiple fetuses, or excessive amniotic fluid. Other causes include retained placenta, inverted or ruptured uterus, and cervical, vaginal or perineal lacerations. Notably, the majority of PPH cases occur in women without these factors and who otherwise have normal pregnancies and labors. “Secondary” PPH, defined as hemorrhage after the first 24 hours but less than 6 weeks postpartum, can be produced by retained placental fragments and infection.
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