Pregnancy is the most wonderful thing that happens to any woman in her entire lifetime. The joy of bringing a new life to the world cannot be measured in words. However, pregnancy brings with it a whole host of discomforts and vulnerabilities, right from raging hormones to hurting legs, hunger and sickness to backache and tiredness. As if these were less, there are other factors as well that should be kept in mind when it comes to giving birth to a new life. One such factor is postpartum bleeding or postpartum hemorrhage (PPH). Hemorrhage may occur before or after the placenta is delivered. The average amount of blood loss after the birth of a single baby in case of a vaginal delivery is about 500 ml, while, for a cesarean birth, the average amount of blood loss is approximately 1,000 ml.
Most postpartum hemorrhage occurs right after delivery (primary PPH), but it can occur later as well (secondary or delayed PPH). For most women, postpartum bleeding ends on its own. However, some women bleed too much after birth and require special treatment. This excessive blood loss is called a postpartum hemorrhage. The condition is more likely to take place in case of cesarean birth. Apart from excessive loss of blood, the other symptoms experienced are lightheadedness, weakness, rapid heartbeat or palpitations, rapid or shallow breathing, clammy skin, restlessness or confusion. To know the causes for postpartum hemorrhage, browse through the following lines.
Postpartum Hemorrhage Causes
- One of the leading causes of postpartum bleeding is placental abruption. The early detachment of the placenta from the uterus can cause bleeding during the postpartum period.
- Another reason for postpartum bleeding is due to excessive enlargement of the uterus, a condition termed as overdistended uterus. This condition mostly occurs due to two factors - excess of amniotic fluid or due to a large baby, who has a birth weight over 8.8 pounds.
- In case of women who give birth to twins or triplings, the chance of experiencing postpartum bleeding runs high. This is mainly because there are basically more than one placenta and overdistention of the uterus.
- Postpartum bleeding can be caused due to bleeding into a concealed tissue area or space in the pelvis. This develops into a hematoma, usually in the vulva or vaginal area.
- Blood clotting disorder such as disseminated intravascular coagulation can also be a reason for postpartum bleeding to occur.
- Placenta accreta is a condition wherein the placenta is unusually attached to the inside of the uterus. In case of such a situation, chances of experiencing postpartum hemorrhage are high.
- When the placental tissues invade the muscle of the uterus, a condition termed as placenta increta, heavy bleeding is caused. Placenta percreta, on the other hand, is a condition wherein the placental tissues go all the way into the uterine muscle and rupture. This condition also causes blood loss.
- Trauma caused to the genital tract during the time of labor, such as use of forceps, uterine rupture, lacerations or vacuum-assisted delivery, can also be the reason for postpartum hemorrhage to occur.
- PIH or pregnancy-induced hypertensionis a condition when an expectant mother has high blood pressure during pregnancy. Such women are at greater risk to experience postpartum hemorrhage.
- Infection due to placental remnants can cause delayed secondary postpartum hemorrhage. This is basically faced after the first 24 hours of birth.
- Low placental implantation is a condition when the placenta implants lower in the uterus than it should be. This causes postpartum blood loss.
- Placenta previa - the placenta covers or is near the cervical opening
- Having many previous births
- Prolonged labor
- Medications to induce labor
- Medications to stop contractions (for preterm labor)
- General anesthesia
- Tear in the cervix or vaginal tissues
- Tear in a uterine blood vessel
- Multiple gestation
- Multipartity (particularly grand multiparity, more than 5 term pregnancies)
- Labor augmented with Pitocin
- Abruptio Placentae
- Magnesium sulfate infusion