Presentation on theme: "Dr.Suresh Babu Chaduvula Professor Dept. of Obstetrics & Gynecology College of Medicine, Abha, KKU, Saudi Arabia."— Presentation transcript:
Dr.Suresh Babu Chaduvula Professor Dept. of Obstetrics & Gynecology College of Medicine, Abha, KKU, Saudi Arabia
Definition: More than 500 ml of blood loss following normal vaginal delivery of the fetus or 1000ml following Cesarean section. Clinically the amount of blood loss from or into the genital tract which will adversely affect the general condition of the patient Hemorrhage leading to fall in hematocrit by 10 %. Incidence – 1 %
1] Primary 2] Secondary Primary – bleeding occurs following delivery of the baby up to 24 hours Primary is two types: A] Third Stage hemorrhage B] True Post Partum hemorrhage
Third Stage hemorrhage: Bleeding occurs before the expulsion of placenta Example- Placenta accreta, retained placenta True Postpartum hemorrhage: Occurs after the expulsion of placenta
Secondary or Delayed or Late Postpartum hemorrhage: Bleeding occurs following delivery of the baby after 24 hours up to 6 weeks.
Contributes for 80 % of PPH Commonest cause of PPH Cause – Faulty retraction of the uterus Etiology: 1] Grand Multipara 2] Over- distension of uterus – Multiple pregnancy, Hydramnios, big baby 3] Anemia
Combination of Atonic and Traumatic: Blood coagulation Disorders: Abruptio Placenta, Jaundice, Thrombocytopenic purpura, HELLP syndrome
Tone Tissue Trauma Thrombin
Vaginal bleeding may be revealed or concealed Alteration in pulse, Blood pressure and Pulse pressure Flabby uterus in atonic uterus
UTEROTONIC DRUGS Routine oxytocic administration in the third stage of labour can reduce the risk of PPH by more than 40% The routine prophylaxis with oxytocics results in a reduced need to use these drugs therapeutically Management of the third stage of labour should therefore include the administration of oxytocin after the delivery of the anterior shoulder.
Early recognition of PPH is a very important factor in management. An established plan of action for the management of PPH is of great value when the preventive measures have failed.