POSTPARTUM HEMORRHAGE

Postpartum Hemorrhage

Briana Jenkins

Jackson College: OB

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Postpartum hemorrhage (PPH) happens after giving birth when the mom experiences heavy

bleeding. PPH is a rare but serious condition taking place anywhere from an hour to weeks once

the baby has been born. The patient and her nurses should be watching for consistent constant

bleeding, drop in blood pressure, pale or clammy skin, blurry vision, nausea, and pain or

swelling of the perineum.

PPH is caused by uterine or placenta problems. Uterine atony occurs when the muscles of

the uterus don't tighten once the woman has given birth. The uterus is supposed to contract to

stop the bleeding from the spot where the placenta was removed from the uterine wall. The next

uterine condition that could cause postpartum hemorrhage is uterine inversion where the uterus

turns inside out after birth. Another situation that could come about, but generally doesn't is

called a uterine rupture. Uterine rupture means the uterus ruptures while the mom is in labor

trying to have the baby; there is an increased risk for a rupture if the patient has had a previous c-

section. A placental issue could arise from a placenta abruption when the placenta detaches from

the uterine wall before giving birth. The placenta may also grow deeply into the uterine wall

causing PPH to take place. The last placenta related circumstance causing postpartum

hemorrhage is a placenta previa. A placenta previa is when the placenta is partially or fully

covering the cervix making the baby push against the placenta causing bleeding. Other

conditions could be fast or prolonged labor, tearing, obesity, previous infection, preeclampsia

(high blood pressure), and having a c-section.

There are many determinates of having PPH. The patients provider may order blood

tests like a blood assay or a clotting factor. The woman's hematocrit is looked at to check the

percent of whole blood in the body with a low hematocit indicating lots of bleeding. A physical

or pelvic exam could be done to look at what is taking place. Blood measurements evaluate the

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amount of blood the woman has lost. Finally, ultrasound is another form used to inspect the

uterus or placenta.

One of the first things that should be done to a woman who could be experiencing PPH is

massaging the fundus. By massaging the fundus, the nurse is trying to get the muscles of the

uterus to contract so the bleeding lessens. The provider could order the patient to take pitocin

which is the medicine form of trying to contract the uterine muscles. If neither of the previous

efforts work and bleeding continues the woman will need a hysterectomy to save her life. A

hysterectomy is a surgery done to remove the uterus.

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References

March of Dimes Foundation. (2016). Postpartum hemorrhage. Retrieved from

http://www.marchofdimes.org/pregnancy/postpartum-hemorrhage.aspx