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Causes of postpartum hemorrhage are uterine atony, trauma, retained placenta or placental abnormalities, and coagulopathy, commonly referred to as the "four Ts": [12] Tone: uterine atony is the inability of the uterus to contract and may lead to continuous bleeding. Retained placental tissue and infection may contribute to uterine atony.
Besides placenta previa and placental abruption, uterine rupture can occur, which is a very serious condition leading to internal or external bleeding. Bleeding from the fetus is rare, but may occur with two conditions called vasa previa and velamentous umbilical cord insertion where the fetal blood vessels lie near the placental insertion site unprotected by Wharton's jelly of the cord. [11]
Chorionic hematoma is the pooling of blood between the chorion, a membrane surrounding the embryo, and the uterine wall. [2] It occurs in about 3.1% of all pregnancies , [ 2 ] it is the most common sonographic abnormality and the most common cause of first trimester bleeding .
A retained placenta is commonly a cause of postpartum haemorrhage, both primary and secondary. [1] Retained placenta is generally defined as a placenta that has not undergone placental expulsion within 30 minutes of the baby’s birth where the third stage of labor has been managed actively. [2]
Normally the maternal circulation and the fetal circulation are kept from direct contact with each other, with gas and nutrient exchange taking place across a membrane in the placenta made of two layers, the syncytiotrophoblast and the cytotrophoblast. Fetal-maternal haemorrhage occurs when this membrane ceases to function as a barrier and ...
Placental abruption occurs in about 1 in 200 pregnancies. [5] Along with placenta previa and uterine rupture it is one of the most common causes of vaginal bleeding in the later part of pregnancy. [6] Placental abruption is the reason for about 15% of infant deaths around the time of birth. [2] The condition was described at least as early as ...
These factors are known to be the primary pathophysiology cause placental disease. Which is considered to be associated with more than half of premature births. [4] Abnormalities present within the spiral arteries lead to higher velocities in blood, in turn causes the maternal villi to shred. [5]
Other causes of fever following delivery include breast engorgement, urinary tract infections, infections of an abdominal incision or an episiotomy, and atelectasis. [ 1 ] [ 2 ] Due to the risks following caesarean section, it is recommended that all women receive a preventive dose of antibiotics such as ampicillin around the time of surgery. [ 1 ]