Postpartum Haemorrhage: What Causes It?

What is Postpartum haemorrhage?

Postpartum Haemorrhage (PPH) occurs when a woman experiences heavy bleeding after giving birth. While it is normal to lose some blood after labour, approximately half a litre for vaginal births, or a litre for caesarean births (C-Section), PPH is defined as losing more than half a litre or a litre of blood within the first 24 hours after childbirth. However, there are cases where PPH happens up to 12 weeks after delivery. 

It is important to treat PPH quickly, as PPH may result in a drastic decrease in blood pressure, which might result in the body going into a state of shock, and in worst-case scenarios, death.

Symptoms of Postpartum haemorrhage

Different individuals will experience symptoms differently. Here are some of the most common symptoms of PPH: 

  1. Uncontrolled bleeding from the vagina that does not slow or stops. 
  2. Signs of low blood pressure, such as having chills, clammy or pale skin, feeling dizzy, sleepiness, fainting, or blurry visions.
  3. Increased heart rate, or an extremely fast heartbeat. 
  4. Swelling and pain around the vagina and/or the perineal area (the area between the vagina and the anus). 
  5. Feeling nauseous or vomiting.

Do take note that these symptoms might be similar to other medical conditions. It is important to consult your doctor for an accurate diagnosis. 

What Causes Postpartum Haemorrhage?

The most common cause of PPH is when the blood vessels in your uterus bleed freely because it did not contract strongly enough when delivering the placenta. 

Other common causes of PPH are: 

  1. If some of your placentae are still attached to the uterus. 

This could cause complications because if your placenta is still attached to your uterus, it might cause the uterus to be inverted, as the placenta exits the uterus, or in the case where your placenta has invaded or ruptured the uterus muscles (Placenta Increta, Placenta Accreta or Placenta Percreta).

2. If you have had multiple births, a large baby (more than 4 kg), or have had a few children previously. 

This happens because your uterus was expanded and stretched to accommodate your baby, but does not have enough time to recover and cannot contract well to stop the bleeding. 

3. Ruptured Uterus

A ruptured uterus can cause excessive bleeding as a result of uterus tears during childbirth. This could also happen if you have previously had a caesarean birth or if you have had other surgeries involving the uterus.

4. Having long labour. 

Having long labour may also cause you to lose more blood than necessary.

5. Blood clotting disorders, such as the Von Willebrand disease or Disseminated Intravascular Coagulation (DIC). 

Conditions such as such can increase the risk of you forming a haematoma, where your blood vessels rupture and form blood clots in your other tissues, organs or other parts of the body. 

While PPH is a rare condition, do check with your doctor if you have any of the symptoms mentioned. Prompt detection and treatment will usually lead to a full recovery. 

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