Page 306 - Critical Maternity & Newborn Health Nursing

Postpartum Hemorrhage

Definition:

Bleeding of more than 500ml. from genital tract within 24hrs after

delivery that affects the general condition of the mother.

- Average blood loss: In normal labor < 500ml. and Cesarean section
< 1000ml.

- Blood loss > 600 ml. can affect maternal general condition.

Types:

(1) Primary postpartum hemorrhage: Bleeding occurs during the

3rd stage of labor or within the first 24 hours after childbirth.

(2) Secondary postpartum hemorrhage: Bleeding occurs after the

first 24 hours until 6 weeks (the end of puerperium).

Primary Postpartum Hemorrhage

Causes:

(A) Placental site of hemorrhage:

1. Uterine atony: is the main cause of primary postpartum

hemorrhage in more than 90% of cases.

The factors that predispose to uterine atony are:

l-Antepartum hemorrhage. 2-Severe anemia.

3-Overdistension of the uterus. 4-Uterine myomas.

5-Prolongecl labor exhausting the uterus.

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