Postpartum Hemorrhage

Causes

Causes of postpartum hemorrhage may be:

• A loss of muscle tone in the womb after birth
• Wounds in the birth canal
• Not fully delivering the placenta
• Bleeding problems in the pregnant woman that make the blood unable to clot (rare)

In some people, uterine inversion or uterine rupture may also be a cause.

Risk Factors

Things that may raise the risk of postpartum hemorrhage are:

• Problems with the placenta
• Multiple babies in the current pregnancy
• A past postpartum hemorrhage
• A fetus that is larger than average
• The use of medicine to speed up labor
• Rapid or lengthy labor
• Pre-eclampsia

Symptoms

The main symptom is heavy blood loss after having a child. There may also be swelling and pain in the pelvic area.

Diagnosis

The doctor will ask about symptoms and past health. An exam will be done to check for bleeding.

Blood tests will be done to check for problems with clotting.

Pictures will be taken to view the pelvic area. This can be done with an ultrasound.

Treatment

Treatment is based on how much bleeding a person has. Options are:

• Replacing lost fluids, such as with a blood transfusion
• Oxygen therapy
• Medicines to make the uterus contract
• Manual massage of the uterus

Some women may need surgery when other methods do not help. The type of surgery done depends on the source of the bleeding.

Prevention

There are no current guidelines to prevent postpartum hemorrhage.