Postpartum Hemorrhage | Types | Causes | Diagnosis | Medical Management | Nursing Management

Postpartum Hemorrhage is the excessive bleeding from genital tract following birth of baby. It is the most common cause of maternal morbidity and mortality around the world.
In normal vaginal delivery, a blood loss of 500 mL is considered normal. Whereas, in case of cesarean delivery it is 1000 mL.
A blood loss of more than 500 mL in normal delivery and more than 1000 mL in cesarean delivery is known as the postpartum hemorrhage. Postpartum Hemorrhage is also defined as any volume of blood loss due to which the general condition of mother deteriorates.
The causes of PPH include 4 Ts, viz., Tome, Tissue, Trauma and Thrombin.
The management of PPH includes several steps including massage, uterotonic drugs, bimanual compression, tight intrauterine packing and uterine artery ligation.
The nursing diagnoses include,
1. Deficient fluid volume related to excessive bleeding after delivery as evidenced by reduced BP, increased hematocrit and altered level of consciousness.
2. Ineffective tissue perfusion related fluid volume deficit as evidenced by prolonged capillary refill time.
3. Risk of infection related to invasive procedures.
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