Post-Partum Hemorrhage(Part 1)Post-Partum Hemorrhage(Part 1)NULL

Post-Partum Hemorrhage(Part 1)

Write up on POST PARTUM HAEMORRHAGE

Postpartum Haemorrhage is the major cause of death of women in India. This is the condition after the delivery of the baby when the woman is bleeding more than 500 ml, which may lead to death sometimes if left untreated. The post-partum haemorrhage is of two types i.e. Primary PPH and secondary PPH, the Primary PPH is the Bleeding happens after the delivery of the baby within 24 hours which further divides in 3rd stage PPH and True PPH. Secondary PPH is the bleeding happens after the 24 hours of delivery till 42 days of termination of pregnancy. There are many causes of bleeding after the delivery of the baby, which can be explained with the 4Ts as Tone, Tissue, Trauma and Thrombin. The Tone of the uterus plays an important role in all these which if not maintain can lead to primary cause of PPH can be due to multiple pregnancy, polyhydramnios, grandmultiparity and so on. The Tissue is related to the retained bits of the placenta or the conceptus parts left inside the uterus. The Trauma related to any injury or tear to the perineum while conducting the delivery or if any bleeder is left unstitched. Last, the Thrombin plays a role in control of bleeding if any clotting factor is missing can lead to bleeding. The management of 3rd stage of labor is the most important aspect during the time of delivery. As the third stage is considered as the crucial stage of labor which needs to be managed properly by active management and expectant management. The expectant management, in which we wait for the placenta to separate and then start expelling it out by controlled cord traction. The active management, in which we give the oxytocin as soon as the baby is delivered followed by massaging the uterus and then delivery it by traction and controlled cord traction.

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