PPH Cause, Risk factor, Symptoms & Management

Postpartum Hemorrhage

Introduction of PPH (Postpartum hemorrhage) – It is severe blood loss through vaginal bleeding after a baby is born. This is a life-threatening condition. Which mostly happens after the delivery of the placenta. But it can happen even after 12 days of delivery.

PPH postpartum hemorrhage

Cause of PPH

PPH causes are described in some points given below-

  • Atonic uterus – The uterus contracts after delivery, and pushes the placenta out as a placental delivery. These contractions help put pressure on the blood vessels in the area of placental attachment. These contractions give a tone to the uterus. When the uterus does not contract strongly, bleeds freely through the blood vessels. This is called an atonic uterus.
  • Cervical and vaginal tear.
  • Tear in the uterine blood vessels.
  • Blood clotting disorder.
  • low platelets or increased INR.
  • Placenta problems (abnormal placentation)
  • The tissue of the placenta that stays attached to the uterus may cause PPH.

Risk factors for postpartum hemorrhage

Below given points are the major risk factors for PPH –

  • Placental abruption.
  • Placenta previa.
  • Over distended uterus:- Large uterus due to big baby and polyhydramnios (more uterine fluids).
  • Multiple pregnancy twins.
  • HDOP- high blood pressure disorder of pregnancy.
  • Multi gravida.
  • Prolonged labor.
  • Infection.
  • Obesity.
  • Forceps and vacuum-assisted delivery.

Symptoms of PPH

  • Uncontrolled bleeding.
  • Decrease blood pressure.
  • Increase pulse rate.
  • Decrease red blood cell count.
  • Dizziness and fainted.


  • Severe vaginal bleeding.
  • Blood investigation – CBC
  • Check for vitals.

Management of postpartum hemorrhage

Here are some important points. that how to do active management of PPH in its early stages.

  • The doctor should find out the cause of PPH. and stop the cause of bleeding first.
  • Uterine massage- which stimulates uterine contractions.
  • Medicines- which help in uterine contractions- like oxytocin.
  • Exploration of the uterine cavity for removing placental tissue.
  • Repair vaginal tear and cervical tear.
  • Bakri balloon and Foley catheter insert Intrauterine. Bakri balloon or Foley catheter to pressure on the bleeding in the uterus. if the Bakri balloon is not available then the uterus is packed with sterile gauze, sponge, and roller gauze.
  • Leprotomy- open abdominal surgery to find out the cause of PPH and feel the bleeding vessels by repairing structure sites.
  • Hysterectomy:-
  • If the above management does not help to stop this thing lastly they should remove the uterus.
  • Blood transfusion in case of excessive blood loss. A blood transfusion may be required to prevent shock and IV Fluids are also required to prevent sock.

Complication of PPH

Shock and death if PPH not treated

Also, Read

Ectopic pregnancy symptoms cause management

What is the Placenta, Types, and Functions

Abruptio Placentae Types signs & Management

Placenta Previa: Its Types and Management

Instruments Used in Gynecology and Obstetrics pdf

Head Injury/Brain Injury Causes & Classification

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