Hemorrhage

Throughout history, blood loss after delivery and its associated complications have accounted for more maternal deaths than any other reason except infection. This is no longer the case when a woman is cared for by a competent clinician supported by a reasonably modern health care system. Overall, approximately 6% of women will have an estimated blood loss of 500 cc or more (that’s about a pint) associated with childbirth. Most of this blood is lost from the inside of the uterus where the placenta was attached. Most often this occurs immediately after the delivery of the placenta. In these cases, instead of contracting and reducing the blood flow to the placental attachment site, the uterus goes flaccid, a condition known as “uterine atony”. If quickly diagnosed, your midwife or doctor will spring into action and with a combination of hand skills and medications facilitate and encourage the uterus to contract.

There are other factors which may contribute to blood loss. Occasionally the wound left by an episiotomy or laceration may tear in to larger blood vessels. Such wounds produce so much blood so quickly that it may take a while to “ligate” the bleeding vessels with sutures. Bleeding may also occur beneath the visible surface. In these situations, blood may pool in pockets producing “hematomas”. Most hematomas stabilize (by clotting) spontaneously. But some may need to be opened and the bleeding vessels tied off with suture. In either case, blood has escaped from the bloodstream. Hematomas most often occur in the spaces on either side of the vagina deep in the pelvis. A woman with a hemtoma may feel an increasingly painful pressure in the vagina or buttocks.

If a woman is suffering the more severe consequences of hemorrhage, a decision may be made to treat her with a blood transfusion. For those women, a doctor or midwife may feel that without a transfusion the possibility of a further decline in health (for example, an infection) could cost a new mother her life. There is no substitute for blood. Although intravenous fluids and plasma may help by preventing shock, it is the oxygen-carrying capacity of red blood cells which keeps our bodies alive.

3 Responses to “Hemorrhage”

  1. Iulia

    Very good reeivw of a harmless condition yet a few other things to consider. There are a few things which rarely occur but need to be kept in mind. A Kaposi’s Sarcoma can mimic a SCH. This is a redish purple lesion beneath the conjunctiva and usually slightly elevated. These people should be evaluated for AIDS. Other conjunctival neoplasms such as lymphoma may be associated with a sub conjunctival hemorrhage. Also if the hemorrhage is caused by significant trauma it is important to rule out a ruptured globe. Lastly patients with recurrent subconunctival hemorrhages should be worked up for a bleeding disorder and hypertension.

    #134
  2. Fatma

    Noah’s Mommy & Expecting AvaApril 25, 2013Nope. HCG is the same for everyone, no meattr how they are built. If you’re pregnant, you’re pregnant. And for what it’s worth, I’m a little overweight and got positives right away with both my pregnancies(3 days late with my son and 2 days late with this one).

    #260
  3. Louise

    I hemorrhage bad when I just gave birth to my third babe and I want to try for another baby but I just want to can it happen again that’s what I’m worried about

    #304

Leave a Reply