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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 ]
Bleeding before childbirth is that which occurs after 24 weeks of pregnancy. [4] Bleeding may be vaginal or less commonly into the abdominal cavity. Bleeding which occurs before 24 weeks is known as early pregnancy bleeding. Causes of bleeding before and during childbirth include cervicitis, placenta previa, placental abruption and uterine rupture.
Across the globe, postpartum hemorrhage is among the top five causes of maternal death. [2] Recognition of the warning signs of uterine atony in the setting of extensive postpartum bleeding should initiate interventions aimed at regaining stable uterine contraction.
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]
Lochia serosa which persists to some weeks after birth can indicate late postpartum hemorrhaging, and should be reported to a physician. Lochia alba (or purulenta) is the name for lochia once it has turned whitish or yellowish-white. It typically lasts from the second through the third to sixth weeks after delivery.
In the immediate postpartum period (puerperium), 87% to 94% of women report at least one health problem. [8] [9] Long-term health problems (persisting after six months postpartum) are reported by 31% of women. [10] In 2016, complications of pregnancy, childbirth, and the puerperium resulted globally in 230,600 deaths, down from 377,000 deaths ...
It is the most common cause of early pregnancy bleeding and is associated only with heavy (versus light) bleeding. [8] However, patients typically remain hemodynamically stable. Threatened early pregnancy loss, often considered a type of early pregnancy loss, refers vaginal bleeding in the presence of an intrauterine pregnancy and a closed cervix.
Women are 4-5 times more likely to develop a clot during pregnancy and in the postpartum period than when they are not pregnant. [25] Hypercoagulability in pregnancy likely evolved to protect women from hemorrhage at the time of miscarriage or childbirth. In developing countries, the leading cause of maternal death is still hemorrhage. [25]