Postpartum Hemorrhage
Postpartum Hemorrhage
Introduction
Postpartum hemorrhage (PPH) is a significantly life-threatening complication that can occur after both vaginal and caesarean births (Ricci & Kyle, 2009). Simpson and Creehan (2008) define PPH as the amount of blood loss after vaginal birth, usually more than 500mL, or after a caesarean birth, normally more than 1000mL. However, the definition is arbitrary, attributed to the fact that loss of blood during birth is intuitive and widely inaccurate (Ricci & Kyle, 2009). In line with this, studies have suggested that health care providers consistently underestimate actual blood loss, thus, an objective definition of PPH would be any amount of bleeding that exposes a mother in hemodynamic jeopardy (Ricci & Kyle, 2009). Currently, PPH is the leading cause of maternal mortality worldwide, and it is estimated that, over 150, 000 women, die of the complication annually (Ricci & Kyle, 2009).
Causes of Postpartum Hemorrhage
Excessive bleeding can occur at any time between the separation of the placenta and its expulsion or removal, and in tandem to this, there are different facets that cause PPH (Simpson & Creehan, 2008). PPH can amount from uterine atony, failure of the uterus to contract and retract after birth (Ricci & Kyle, 2009). Uterine atony is the most common cause of PPH, accounting for 70% of cases (Sheiner, 2011), and it is usually delineated by a marked hypotonia of the uterus (Simpson & Creehan, 2008). In addition, uterine atony is likely to occur when the uterus is over distended, depicted through polyhydramnios, multiple gestations, and macrosomia (Simpson & Creehan, 2008). Other factors that induce uterine atony encompass; traumatic birth, halogenated anaesthesia, lengthened labour, induction or augmentation of labour, intraamniotic infection, tocolytics, and multiparity (Simpson & Creehan, 2008).
Sheiner (2011) also affirms that trauma is a significant cause of PPH, and it is typically associated with vaginal or birth canal
Introduction
Postpartum hemorrhage (PPH) is a significantly life-threatening complication that can occur after both vaginal and caesarean births (Ricci & Kyle, 2009). Simpson and Creehan (2008) define PPH as the amount of blood loss after vaginal birth, usually more than 500mL, or after a caesarean birth, normally more than 1000mL. However, the definition is arbitrary, attributed to the fact that loss of blood during birth is intuitive and widely inaccurate (Ricci & Kyle, 2009). In line with this, studies have suggested that health care providers consistently underestimate actual blood loss, thus, an objective definition of PPH would be any amount of bleeding that exposes a mother in hemodynamic jeopardy (Ricci & Kyle, 2009). Currently, PPH is the leading cause of maternal mortality worldwide, and it is estimated that, over 150, 000 women, die of the complication annually (Ricci & Kyle, 2009).
Causes of Postpartum Hemorrhage
Excessive bleeding can occur at any time between the separation of the placenta and its expulsion or removal, and in tandem to this, there are different facets that cause PPH (Simpson & Creehan, 2008). PPH can amount from uterine atony, failure of the uterus to contract and retract after birth (Ricci & Kyle, 2009). Uterine atony is the most common cause of PPH, accounting for 70% of cases (Sheiner, 2011), and it is usually delineated by a marked hypotonia of the uterus (Simpson & Creehan, 2008). In addition, uterine atony is likely to occur when the uterus is over distended, depicted through polyhydramnios, multiple gestations, and macrosomia (Simpson & Creehan, 2008). Other factors that induce uterine atony encompass; traumatic birth, halogenated anaesthesia, lengthened labour, induction or augmentation of labour, intraamniotic infection, tocolytics, and multiparity (Simpson & Creehan, 2008).
Sheiner (2011) also affirms that trauma is a significant cause of PPH, and it is typically associated with vaginal or birth canal
References: Ricci, S. S. & Kyle, T. (2009). Maternity and Pediatric Nursing. Philadelphia, PA: Wolters Kluwer Health/ Lippincott Williams & Wilkins. Sheiner, K. E. (Ed.). (2011). Bleeding During Pregnancy: A Comprehensive Guide. New York, NY: Sringer Science + Business Media, LLC. Simpson, R. K. & Creehan, A. P. (2008). Perinatal Nursing (3rd Ed.). Philadelphia, PA: Lippincott Williams & Wilkins.