Tuesday, March 1, 2011

Post-partum haemorrhage

Post-partum haemorrhage

     * Introduction
     * Diagnosis
     * Treatment

Consider a post-partum hemorrhage in bleeding exceeding 500 ml in a vaginal delivery of a fetus, or greater than 1000 ml in caesarean section. In the case of twin pregnancy is considered normal average loss is around 1000 ml. Bleeding occurs immediately post-partum, but can also happen in the first 24 hours. Bleeding occurred after the first 24 hours is called post-partum haemorrhage late.


Common causes are uterine atony and vaginal and cervical lacerations. Other causes of post-partum haemorrhage are:
is caused by bleeding in the post-partum are:
- episiotomy large;
- uterine rupture;
- Uterine atony is favored by: general anesthesia with halogenated compounds, low myometrial perfusion pressure that lowers the uterus supradestins (hidramnios, twins, macrosomia), prolonged labor, labor precipitate labor with oxytocin initiated and led, multiparous, corioamniotita;
- retention of placental tissue;
- bleeding disorders;

Wrong attitude during delivery, in the sense of manual stimulation uetrului already contracted, will prevent the physiological mechanism of placental detachment, causing incomplete separation of the placenta and increased blood pirderii.

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