Post partum haemorrhage or bleeding after giving birth is still the main cause of death in pregnant women, especially in developing countries.Some of the accompanying symptoms of postpartum hemorrhage include:increased heart rate, decreased blood pressure,and vaginal pain.
Post partum bleeding is generally due to the opening of blood vessels in the uterus where the placenta attaches to the uterine wall during pregnancy. In addition, blood can also come out of the tear in the birth canal that occurs when a woman goes through an episiotomy procedure during childbirth.
Various Causes of Post Partum Bleeding
Each patient's body has a different reaction when bleeding occurs. However, there are some cases where postpartum hemorrhage is more severe. The following are various things that can cause excessive post partum bleeding:postpartum hemorrhage (PPH):
- The presence of postpartum hemorrhage that occurs due to a tear or a wide episiotomy incision in the perineum or vagina.
- Uterine atony is a condition where the uterine muscle tone is lost so that it cannot contract, compressing the vessels and reducing blood flow. This situation is a major cause of postpartum hemorrhage and can be caused by other pregnancy conditions, such as polyhydramnios.
- Placenta previa is a condition when the baby's placenta completely or partially covers the cervix, which connects it to the top of the vagina.
- Retention of the placenta, which is a condition when part or all of the placental tissue does not come out after delivery
- Deficiency of the enzyme thrombin can cause bleeding disorders due to failure of blood clotting.
- A ruptured (ruptured) uterus can also cause postpartum hemorrhage. However, this case is a rare condition.
How to Overcome Post Partum Bleeding and its Prevention
The goal of treating postpartum hemorrhage is to stop the cause of the bleeding as soon as possible. Here are some ways to deal with postpartum hemorrhage:
- Oxytocin massage and infusionAfter the placenta comes out, the uterus should continue to contract until the blood vessels close again. However, under certain conditions, contraction does not occur. This process can usually be assisted by nurses by massaging the abdomen, this action is known as uterine fundus massage. In addition, the process of breastfeeding which releases the natural hormone oxytocin can also help speed up this process. In addition, doctors can give synthetic oxytocin hormone through an IV to help contractions.
- balloon catheter FoleyInflating a Foley balloon catheter, which is placed in the uterus, can put pressure on the open blood vessels. This action helps stop the bleeding temporarily, until other measures can be taken.
- Remove the placenta
Placenta that has not been expelled needs to be removed manually immediately. This procedure will be performed by a trained doctor or midwife. Previously will be given pain medication.
- Drugs to stimulate uterine contractions
While continuing to massage, the doctor will give drugs other than oxytocin, to stimulate uterine contractions so as to stop bleeding.
The doctor may also need to examine the remaining placenta in the uterus by inserting a hand into the vagina. In some cases, a curettage may be necessary to clean the uterus and remove the remaining placenta.
In more severe cases, a laparotomy (abdominal surgery) may be needed to find the cause of the bleeding or even a hysterectomy, which is surgical removal of the uterus to stop postpartum bleeding. Hysterectomy is a last resort in most cases.
After the bleeding stops, the patient may feel very weak. Therefore, the patient will receive intravenous fluids and blood transfusions. Women who experience postpartum haemorrhage may also have anemia so they need plenty of rest and consume adequate fluids and nutritious foods. Your doctor may prescribe folic acid and iron supplements.
To prevent post partum bleeding, it can be done through regular pregnancy check-ups. Your obstetrician will perform an examination, and consider your risk factors and conditions during pregnancy. If you have a rare blood type, a bleeding disorder, or a history of postpartum hemorrhage, your doctor can prepare an appropriate delivery plan.
