Presentation on theme: "Postpartum Hemorrhage"— Presentation transcript:
1Postpartum Hemorrhage Dr.Suresh Babu ChaduvulaProfessorDept. of Obstetrics & GynecologyCollege of Medicine, Abha, KKU, Saudi Arabia
2POSTPARTUM HEMORRHAGE [ PPH ] 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 patientHemorrhage leading to fall in hematocrit by 10 %.Incidence – 1 %
3TYPES 1] Primary 2] Secondary Primary – bleeding occurs following delivery of the baby up to 24 hoursPrimary is two types:A] Third Stage hemorrhageB] True Post Partum hemorrhage
4Third Stage hemorrhage: Bleeding occurs before the expulsion of placentaExample- Placenta accreta, retained placentaTrue Postpartum hemorrhage:Occurs after the expulsion of placenta
5Secondary or Delayed or Late Postpartum hemorrhage: Bleeding occurs following delivery of the baby after 24 hours up to 6 weeks.
7Atonic PPH Contributes for 80 % of PPH Commonest cause of PPH Cause – Faulty retraction of the uterusEtiology:1] Grand Multipara2] Over- distension of uterus – Multiple pregnancy, Hydramnios, big baby3] Anemia
84] Prolonged Labor5] Anaesthesia – Halothane. Ether,Cyclopropane6] Uterine fibroid7] Precipitate labor8] Malformations of uterus – septate uterus, bicornuate uterus9] Ante partum hemorrhage10] Initiation & augmentation of delivery with oxytocin
18PREVENTION OF PPH 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 therapeuticallyManagement of the third stage of labour should therefore include the administration of oxytocin after the delivery of the anterior shoulder.
19MANAGEMENT OF PPHEarly 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.