Post-Partum Haemorrhage
Jul 23, 2024
A 28 yo otherwise well patient has presented to the emergency department with an imminent delivery. The baby is delivered and there is some vaginal bleeding post delivery, however it doesn't appear significant. The patient is complaining that she is feeling unwell. Her heart rate has increased to 142 bpm. Is this a potential haemorrhage to be concerned about?
Postpartum haemorrhage(PPH) is the leading cause of maternal mortality. It's overall rate is 5 - 15% but most of these cases are minor. It is considered a primary haemorrhage if it occurs within 24hours of delivery and secondary when it occurs after this and up to six weeks post partum. The management of post abortion haemorrhage is similar to PPH.
The definition of PPH includes:
- Blood loss of 500ml or more during puerperium
- Severe PPH is defined as
- a blood loss of 1000ml or more, or
- signs of haemodynamic compromise regardless of the estimated volume of blood loss. This can be as simple as a tachycardia in the example above.
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