Postpartum Hemorrhage

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Postpartum Hemorrhage
Postpartum hemorrhage (PPH) is a significantly life-threatening complication that can occur after both vaginal and caesarean births (Ricci & Kyle, 2009). Simpson and Creehan (2008) define PPH as the amount of blood loss after vaginal birth, usually more than 500mL, or after a caesarean birth, normally more than 1000mL. However, the definition is arbitrary, attributed to the fact that loss of blood during birth is intuitive and widely inaccurate (Ricci & Kyle, 2009). In line with this, studies have suggested that health care providers consistently underestimate actual blood loss, thus, an objective definition of PPH would be any amount of bleeding that exposes a mother in hemodynamic jeopardy (Ricci &
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The sign and symptoms of PPH include; the apparent excessive bleeding, hematocrit-reduction of the number of red blood cells, reduced blood pressure, development of symptoms of shock and anaemia, and severe pain and swelling of tissues and muscles of the vagina, vulva, pelvic and perineum (Simpson & Creehan, 2008). Besides, Ricci & Kyle (2009) avow that there are different factors that place a mother at risk for PPH, and they comprise; prolonged first, second or third stage of labour, previous history of PPH, foetal macrosomia, uterine infection, arrest of descent and multiple gestation. Other risk factors may include; mediolateral episiotomy, coagulation abnormalities, maternal hypertension, maternal exhaustion, malnutrition or anaemia, preeclampsia, precipitous birth, polyhydramnios and previous placenta previa (Ricci & Kyle, 2009).
Diagnosis and Assessment
The principal mode of diagnosis is a differential diagnosis, and it includes a plethora of facets; bleeding from implantation site, which may be due to uterine atony, with predisposing factors such as infections, and retained placenta or abnormal placentation (Sheiner, 2011). Coagulation disorders and trauma are also essential facets considered during diagnosis (Sheiner, 2011). Conventionally, there are different methods used for the estimation of blood loss during diagnosis, and they are majorly classified as clinical and quantitative methods (Ricci & Kyle, 2009). Clinical method remains the primary means to
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