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Understanding Maternal Haemorrhage

Posted: April 22, 2020

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Postpartum hemorrhage or maternal hemorrhage refers to the excessive blood loss after the childbirth. It is treatable but needs emergency care.

Postpartum hemorrhage occurs when a pregnant women experiences excessive bleeding after the delivery of the baby. About 1 in 100 to 5 in 100 women experience postpartum hemorrhage. It is more common in the cesarean process than the natural process of giving birth. Maternal Hemorrhage often happens after the placenta is delivered. It is one of the leading cause of preventable maternal deaths worldwide.

What are the causes of Maternal Haemorrhage?

After the delivery, the uterus usually contracts and pushes out the placenta. These contractions help put pressure on the bleeding vessels in the area where the placenta was attached at the time of birth. If the uterus does not contract strongly enough, the blood vessels bleed freely, causing postpartum haemorrhage.

Other causes may include:

  • Tear in the cervix or the tissue of the vagina
  • Tear in a blood vessel in the uterus
  • Bleeding into a hidden tissue area or space in the pelvis
  • Blood clotting disorders
  • Placenta problems 

What are the conditions that may increase the risk of maternal haemorrhage?

  • Placenta Abruption (early detachment of the placenta from the uterus)
  • Placenta Previa (when the placenta covers or is near the opening of the cervix)
  • Overdistended Uterus (where the uterus is larger than normal because of excess amniotic fluid or a larger baby)
  • Multiple Baby Pregnancy
  • Having Many Previous Births
  • Prolonged Labor
  • Obesity 
  • Infection 
  • Use of forceps or vacuum-assisted delivery

What are the symptoms of maternal haemorrhage?

  • Uncontrolled bleeding
  • Decreased blood pressure
  • Increased heart rate
  • A decrease in the red blood cell count
  • Swelling and pain in and around the vagina.

How is maternal haemorrhage treated?

  • Medicine or uterine massage to stimulate contractions.
  • Removing pieces of the placenta that remains in the uterus. 
  • Examining the uterus and other pelvic tissues, the vagina and vulva to look for areas that may need repair.
  • Laparotomy (surgery done to open the abdomen to find the cause of bleeding)
  • Tying off or sealing blood vessels (done using uterine compression sutures, special gel, glue or coils)
  • Hysterectomy (surgery done to remove the uterus)

It is important to replace lost blood in treating maternal haemorrhage. You may quickly be given fluids, blood, and blood products to prevent shock. Oxygen will also help in such situations. Maternal haemorrhage must be taken seriously by all pregnant women. The problem can be nipped in the bud if the cause of bleeding can be found quickly, it can be treated and you will be able to recover fully.

image credits: Pixabay

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