𝐏𝐨𝐬𝐭𝐩𝐚𝐫𝐭𝐮𝐦 𝐇𝐞𝐦𝐨𝐫𝐫𝐡𝐚𝐠𝐞 - part 1 || Obstetrics & gynaecology

📌𝐅𝐨𝐥𝐥𝐨𝐰 𝐨𝐧 𝐈𝐧𝐬𝐭𝐚𝐠𝐫𝐚𝐦:-   / drgbhanuprakash  
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𝐏𝐨𝐬𝐭𝐩𝐚𝐫𝐭𝐮𝐦 𝐇𝐞𝐦𝐨𝐫𝐫𝐡𝐚𝐠𝐞

𝐖𝐡𝐚𝐭 𝐢𝐬 𝐩𝐨𝐬𝐭𝐩𝐚𝐫𝐭𝐮𝐦 𝐡𝐞𝐦𝐨𝐫𝐫𝐡𝐚𝐠𝐞?
Postpartum hemorrhage is more bleeding than normal after the birth of a baby. About 1 in 100 to 5 in 100 women have postpartum hemorrhage. It's more likely with a cesarean birth. It most often happens after the placenta is delivered, but it can also happen later.

𝐖𝐡𝐚𝐭 𝐜𝐚𝐮𝐬𝐞𝐬 𝐩𝐨𝐬𝐭𝐩𝐚𝐫𝐭𝐮𝐦 𝐡𝐞𝐦𝐨𝐫𝐫𝐡𝐚𝐠𝐞?
Once a baby is delivered, the uterus normally contracts and pushes out the placenta. After the placenta is delivered, these contractions help put pressure on the bleeding vessels in the area where the placenta was attached. If the uterus does not contract strongly enough, these blood vessels bleed freely. This is the most common cause of postpartum hemorrhage. If small pieces of the placenta stay attached, bleeding is also likely.

Postpartum hemorrhage may also be caused by

Tear in the cervix or tissues of the vagina
Tear in a blood vessel in the uterus
Bleeding into a hidden tissue area or space in the pelvis. This mass of blood is called a hematoma. It's usually in the vulva or vagina.
Blood clotting disorders
Placenta problems


𝐖𝐡𝐨 𝐢𝐬 𝐚𝐭 𝐫𝐢𝐬𝐤 𝐟𝐨𝐫 𝐩𝐨𝐬𝐭𝐩𝐚𝐫𝐭𝐮𝐦 𝐡𝐞𝐦𝐨𝐫𝐫𝐡𝐚𝐠𝐞?
Some women are at greater risk for postpartum hemorrhage than others. Conditions that may increase the risk include:

Placental abruption. This is the early detachment of the placenta from the uterus.
Placenta previa. This is when the placenta covers or is near the opening of the cervix.
Overdistended uterus. This is when the uterus is larger than normal because of too much amniotic fluid or a large baby.
Multiple-baby pregnancy
High blood pressure disorders of pregnancy
Having many previous births
Prolonged labor
infection
Obesity
Use of forceps or vacuum-assisted delivery
Being of Asian or Hispanic ethnic background

𝐖𝐡𝐚𝐭 𝐚𝐫𝐞 𝐭𝐡𝐞 𝐬𝐲𝐦𝐩𝐭𝐨𝐦𝐬 𝐨𝐟 𝐩𝐨𝐬𝐭𝐩𝐚𝐫𝐭𝐮𝐦 𝐡𝐞𝐦𝐨𝐫𝐫𝐡𝐚𝐠𝐞?
These are the most common symptoms of postpartum hemorrhage

Uncontrolled bleeding
Decreased blood pressure
Increased heart rate
Decrease in the red blood cell count
Swelling and pain in the vagina and nearby area if bleeding is from a hematoma
The symptoms of postpartum hemorrhage may look like other health conditions. Always see your healthcare provider for a diagnosis.

𝐇𝐨𝐰 𝐢𝐬 𝐩𝐨𝐬𝐭𝐩𝐚𝐫𝐭𝐮𝐦 𝐡𝐞𝐦𝐨𝐫𝐫𝐡𝐚𝐠𝐞 𝐝𝐢𝐚𝐠𝐧𝐨𝐬𝐞𝐝?
Your healthcare provider will review your health history and do a physical exam. Lab tests often help with the diagnosis. Other tests may include:

Estimate of how much blood you have lost
Measuring pulse and blood pressure
Red blood cell count
Clotting factors in the blood

𝐇𝐨𝐰 𝐢𝐬 𝐩𝐨𝐬𝐭𝐩𝐚𝐫𝐭𝐮𝐦 𝐡𝐞𝐦𝐨𝐫𝐫𝐡𝐚𝐠𝐞 𝐭𝐫𝐞𝐚𝐭𝐞𝐝?
The aim of the treatment of postpartum hemorrhage is to find and stop the cause of the bleeding as soon as possible. Treatment may include:

Medicine or uterine massage to stimulate uterine contractions
Removing pieces of the placenta that remain in the uterus
Exam of the uterus and other pelvic tissues, the vagina, and the vulva to look for areas that may need repair
Bakri balloon or a Foley catheter to put pressure on the bleeding inside the uterus. Your healthcare provider may pack the uterus with sponges and sterile materials. This may be done if a Bakri balloon or Foley catheter is not available.
Laparotomy. This is surgery to open the abdomen to find the cause of bleeding
Tying off or sealing bleeding blood vessels. This is done using uterine compression sutures, special gel, glue, or coils. The surgery is done during a laparotomy.
Hysterectomy. This is surgery to remove the uterus. In most cases, this is a last resort.
Replacing lost blood and fluids is important in treating postpartum hemorrhage. You may quickly be given IV (intravenous) fluids, blood, and blood products to prevent shock. Oxygen may also help.
Postpartum hemorrhage can be quite serious. But when your provider quickly finds and treats the cause of bleeding, you often will be able to recover fully.

𝐖𝐡𝐚𝐭 𝐚𝐫𝐞 𝐩𝐨𝐬𝐬𝐢𝐛𝐥𝐞 𝐜𝐨𝐦𝐩𝐥𝐢𝐜𝐚𝐭𝐢𝐨𝐧𝐬 𝐨𝐟 𝐩𝐨𝐬𝐭𝐩𝐚𝐫𝐭𝐮𝐦 𝐡𝐞𝐦𝐨𝐫𝐫𝐡𝐚𝐠𝐞?
Losing lots of blood quickly can cause a severe drop in your blood pressure. This may lead to shock and death if not treated

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