Talking about the post delivery bleeding which is an important clinical situation which can have some serious consequences on the health of woman if not managed properly at the same time, Dr Shivani Sachdev Gour, Gynaecologist and IVF Expert, SCI Healthcare shares her views on how one can manage the situation. She says that its management involves an aggressive approach which includes resuscitation of the compromised mother and also to find out the cause of bleeding. This involves oxygen administration, bimanual massage of uterus, immediate intravenous fluid administration and certain injections to contract the uterus which can stop the bleeding. If the blood loss is excessive, the woman might need blood transfusion. If the bleeding persists even after massage and injections then there may be some retained placental tissue or there might be a traumatic cause for which the patient needs to be shifted to the operating room and complete exploration of the genital tract is required by an expert and experienced assistants for evidence of any injury. She lists out absence of blood transfusion facilities and ignorance of illiterate women is the factors contributing to excessive bleeding after delivery. It can cause infection, blood transfusion reactions, thrombosis and failed lactation. In order to prevent post delivery bleeding one should pay proper attention to nutrition and a balanced diet should be taken daily.
After the delivery of baby, there is bleeding from the uterine bed from where the placenta is detached. This bleeding is stopped by effective contraction of the uterus. Bleeding after delivery may continue for about a month but becomes lesser in amount and pinkish in the later days. It consists of blood and shedding of the uterine lining. Excessive post delivery bleeding is an important clinical situation which can have some serious consequences on the health of the woman if not managed properly at the right time. It can occur either after a vaginal birth or following cesarean section.
In medical terms Post delivery bleeding has been defined as excessive if the blood loss following vaginal delivery is more than 500ml or in case of C Section more than 1 Litre. But sometimes blood loss even less than this cut off may be poorly tolerated by the mother if she is anemic. It is a clinical emergency which has to be dealt with immediately in the form of fixed protocol. This is defined as PPH (Post Partum Haemorrhage) drill which has to be followed by the attending obstetrician along with the team members.