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Postpartum bleeding or postpartum hemorrhage (PPH) is often defined as the loss of more than 500 ml or 1,000 ml of blood following childbirth. [2] Some have added the requirement that there also be signs or symptoms of low blood volume for the condition to exist. [ 6 ]
Other definitions of excessive postpartum bleeding are hemodynamic instability, drop of hemoglobin of more than 10%, [12] or requiring blood transfusion. In the literature, primary postpartum hemorrhage is defined as uncontrolled bleeding that occurs in the first 24 hours after delivery while secondary hemorrhage occurs between 24 hours and six ...
It is estimated that less than 1ml of fetal blood is lost to the maternal circulation during normal labour in around 96% of normal deliveries. [1] [2] The loss of this small amount of blood may however be a sensitising event and stimulate antibody production to the foetal red blood cells, an example of which is Rhesus disease of the newborn.
Uterine atony is the most common cause of postpartum hemorrhage, which is an emergency and potential cause of fatality. Across the globe, postpartum hemorrhage is among the top five causes of maternal death. [2]
Postpartum hemorrhage is the leading cause of maternal mortality worldwide [23] [24] In low-resource settings, timely access to surgical facilities may be limited by transport time to tertiary care. Uterine balloon tamponade provides a necessary option to tamponade bleeding while transport occurs to higher levels of care.
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]
A recent study involving 50 cases was carried out by the department of Obstetrics and Gynecology at University Central Hospital in Helsinki, Finland. With an overall success rate of 86%, the authors concluded that the Bakri balloon tamponade is "a simple, readily available, effective and safe procedure" in the management of postpartum hemorrhage.
[1] [2] Compared to surgical treatment for fibroids such as a hysterectomy, in which a woman's uterus is removed, uterine artery embolization may be beneficial in women who wish to retain their uterus. Other reasons for uterine artery embolization are postpartum hemorrhage and uterine arteriovenous malformations. [3]