POST PARTUM HAEMORRHAGE SIMPLIFIED
Primary post-partum haemorrhage is the loss of >500 ml of blood per-vagina within 24 hours of delivery. It can be classified into two main types: Minor PPH – 500-1000ml of blood loss Major PPH – >1000ml of blood loss It is a major cause of obstetric morbidity and mortality worldwide. Aetiology and Risk Factors: The causes for primary post-partum haemorrhage can be broadly categorised by the 4 T’s – t one, t issue, t rauma and t hrombin. Tone ‘Tone’ refers to uterine atony , which is the most common cause of primary post-partum haemorrhage. This is where the uterus fails to contract adequately following delivery, due to a lack of tone in the uterine muscle. The risk factors for uterine atony include: Maternal profile : Age >40, BMI > 35, Asian ethnicity. Uterine over-distension – multiple pregnancy, polyhydramnios, fetal macrosomia. Labour – induction , prolonged (>12 ...