Postpartum Haemorrhage Causes and Nursing Management

Postpartum Haemorrhage Causes and Nursing Management

Postpartum Haemorrhage Causes and Nursing Management : Primary postpartum haemorrhage is defined as a loss of more than 500 ml of blood within 24 hours after vaginal delivery or more than 1000 ml of blood after a caesarean section.Postpartum haemorrhage can be atonic, traumatic or due to coagulation failure (tone, tissue, trauma, thrombin).

Postpartum Haemorrhage Causes

Atonic Postpartum Haemorrhage

  • Retained placenta or placental parts (tissue)
  • Multiple pregnancy (uterine atony due to over distension and a large placental site)
  • Polyhydramnios (uterine atony due to over distension)
  • Prolonged labour (uterine atony)
  • Placental abruption (uterine atony and coagulation failure.
  • Placenta previa
  • Grand multiparity (uterine atony due to the presence of more fibrous tissue)
  • Deep general anaesthesia (uterine atony due to halothane.
  • Submucous fibroids
  • Uterine abnormalities
  • Anaemia

Traumatic Postpartum Haemorrhage

  • Normal labour / precipitate labour
  • Instrumental delivery
  • Caesarean section
  • Episiotomy
  • Uterine rupture
  • Uterine inversion

Coagulation Failure

  • Placental abruption
  • Eclampsia
  • Sepsis
  • Prolonged intrauterine death
  • Amniotic fluid embolism
  • Anti-coagulant therapy
  • Preexisting coagulation problems

Postpartum Haemorrhage Nursing Management

Resuscitation is the first step in the management of an emergency. However, diagnosis and treatment should take place simultaneously.

  • The first step is to insert two 14 gauge cannulae and commence intravenous crystalloids (2 liters of Hartman’s solution) and colloids (1.5 liters), till blood is available.
  • Assess airway and breathing. Give oxygen by face mask at 10—15 liters/ minute.
  • Crossmatch 6 units of blood. Commence transfusion as soon as possible, because the circulating volume should be restored with blood. Uncross-matched O Rhesus negative blood can be given
    initially if the patient is collapsed.
  • Keep the patient warm.
  • Take blood for baseline full blood count and coagulation screen.
  • Adequate amount of blood should be transfused to restore the circulating volume.

Postpartum Haemorrhage Treatment

  • Intravenous broad spectrum antibiotics.
  • Resuscitation and blood transfusion if bleeding is profuse
  • Ultrasound scanning to exclude retained placental tissue.
  • Blood and high vaginal swab for culture and ABST if there is sepsis.
  • Evacuation of retained placental tissue if present.

Please note that this article is for informational purposes only and should not substitute professional medical advice.

Name -Parika Parika holds a Master's in Nursing and is pursuing a Ph.D. in Nursing. In addition to her clinical experience, Parika has also served as a nursing instructor for the past 10 years, she enjoys sharing her knowledge and passion for the nursing profession.


Please enter your comment!
Please enter your name here

Share this

Recent articles


More like this