Postpartal Hemorrhage

Any blood loss from the uterus greater than 500 mL within a 24-hour period.

Hemorrhage

A significant cause of maternal mortality associated with childbearing, posing a threat throughout pregnancy and in the immediate postpartal period.

Postpartal Hemorrhage

Relaxation of the uterus, which is the most frequent cause of postpartal hemorrhage.

Uterine Atony

A factor that predisposes to poor uterine tone or any inability to maintain a contracted state due to the use of medication that numbs pain and induces sleep or sedation.

Deep anesthesia or analgesia

A factor that predisposes to poor uterine tone or any inability to maintain a contracted state due to the use of a medication that stimulates contractions during labor.

Labor initiated or assisted with an oxytocin agent

A factor that predisposes to poor uterine tone or any inability to maintain a contracted state in mothers aged more than 35 years old.

Maternal age greater than 35 years

A factor that predisposes to poor uterine tone or any inability to maintain a contracted state in mothers who have had multiple pregnancies.

High parity

A factor that predisposes to poor uterine tone or any inability to maintain a contracted state due to past surgical procedures on the uterus.

Previous uterine surgery

A factor that predisposes to poor uterine tone or any inability to maintain a contracted state due to prolonged and challenging labor.

Prolonged and difficult labor

A factor that predisposes to poor uterine tone or any inability to maintain a contracted state due to bacterial infection of the fetal membranes.

Possible chorioamnionitis

A factor that predisposes to poor uterine tone or any inability to maintain a contracted state due to pre-existing medical conditions such as anemia.

Secondary maternal illness (e.g., anemia)

A factor that predisposes to poor uterine tone or any inability to maintain a contracted state due to a history of excessive bleeding after childbirth.

Prior history of postpartum hemorrhage

A factor that predisposes to poor uterine tone or any inability to maintain a contracted state due to inflammation of the uterine lining.

Endometritis

A factor that predisposes to poor uterine tone or any inability to maintain a contracted state due to the prolonged use of magnesium sulfate or other medications used to suppress contractions.

Prolonged use of magnesium sulfate or other tocolytic therapy

A procedure involving using both hands to compress and massage the uterus in the event of uterine atony.

Bimanual Massage

A diagnostic imaging procedure that may be done to detect possible retained placental fragments if fundal massage and administration of oxytocin or methylergonovine are not effective in stopping uterine bleeding.

Sonogram

Hormones that promote strong, sustained uterine contractions; intramuscular injection of a specific type of this hormone is another way to initiate uterine contractions.

Prostaglandin Administration

A treatment involving transfusion to replace blood loss with postpartal hemorrhage.

Blood Transfusion

Small lacerations or tears of the birth canal that are common and may be considered a normal consequence of childbearing.

Lacerations or tears of the birth canal

A birth complication that occurs most often with difficult or very rapid labor, in first-time mothers, with the birth of a large baby (9 lb), or when using the lithotomy position and medical instruments during delivery.

Lacerations

Lacerations

A birth complication that occurs most often with difficult or very rapid labor,

in first-time mothers, with the birth of a large baby (9 lb), or when using the lithotomy position and medical instruments during delivery.

Lacerations of the cervix are usually found on the sides of the cervix, near the branches of the uterine artery. If the artery is torn, the blood loss may be so great that blood gushes from the vaginal opening. Because this is arterial bleeding, it is brighter red than the venous blood lost with uterine atony.

Large lacerations

Repair of this type of laceration is difficult because the bleeding can be so intense that it obstructs visualization of the area.

Cervical Lacerations

Although they are rare, lacerations can also occur in this part of the body. They are easier to assess than cervical lacerations because they are easier to view.

Vaginal Lacerations

Because the tissue in this area is friable, lacerations here are also hard to repair. Some oozing often occurs after a repair, so the area may be packed to maintain pressure on the suture line.

Vaginal Lacerations

These lacerations usually occur when a woman is placed in a lithotomy position for birth because this position increases tension in the area.

Perineal Lacerations

These lacerations are sutured and treated as an episiotomy repair.

Perineal Lacerations

Occasionally, a placenta does not deliver in its entirety; fragments of it separate and are left behind.

Retained Placental Fragments

The necessary procedure to stop bleeding due to retained placental fragments, usually involving dilation and scraping of the uterine lining.

Dilatation and Curettage (D&C)

Prolapse of the fundus of the uterus through the cervix so that the uterus turns inside out. This usually occurs immediately after birth.

Uterine Inversion

A deficiency in clotting ability caused by vascular injury. It may occur in any woman in the postpartal period, but it is usually associated with premature separation of the placenta, a missed early miscarriage, or fetal death in utero.

Disseminated Intravascular Coagulation (DIC)

Incomplete return of the uterus to its pre-pregnant size and shape. At a 4- or 6-week postpartal visit, the uterus is still enlarged and soft, and lochial discharge usually is still present.

Subinvolution

Oral administration of methylergonovine, 0.2 mg four times daily, is usually prescribed to improve uterine tone and complete involution. If the uterus is tender to palpation, suggesting endometritis, an oral antibiotic also will be prescribed.

Subinvolution

Subinvolution

Oral administration of methylergonovine, — mg four times daily, is usually prescribed to improve uterine tone and complete involution. If the uterus is tender to palpation, suggesting endometritis, an oral antibiotic also will be prescribed.

0.2

An infection of the breast that may occur as early as the seventh postpartal day or not until the baby is weeks or months old. The organism causing the infection usually enters through cracked and fissured nipples.

Mastitis

Mastitis

An infection of the breast that may occur as early as the seventh — or not until the baby is weeks or months old. The organism causing the infection usually enters through cracked and fissured nipples.

postpartal day

Mastitis

An infection of the breast that may occur as early as the seventh postpartal day or not until the baby is weeks or months old. The organism causing the infection usually enters through —

cracked and fissured nipples

Treatment of this condition consists of antibiotics. Breastfeeding is continued because keeping the breast emptied of milk helps to prevent bacterial growth

Mastitis

A Woman Whose Child Is Born With an Illness or Is Physically Challenged

Most women say during pregnancy they do not care about the sex of their child so long as the child is born healthy. This can make them feel cheated when this one requirement is not met. They can feel ——

angry, hurt, and disappointed

Almost every woman notices some immediate (1 to 10 days postpartum) feelings of sadness (postpartal "blues") after childbirth. This probably occurs as a response to the anticlimactic feeling after birth and hormonal shifts.

Postpartal Depression

Postpartal Depression

Almost every woman notices some immediate (1 to 10 days postpartum) feelings of sadness (postpartal "blues") after childbirth. This probably occurs as a response to the — after birth and hormonal shifts.

anticlimactic feeling

A severe mental illness where a woman usually appears exceptionally sad. This condition exists when a person has lost contact with reality and requires referral to a professional psychiatric counselor and antipsychotic medication.

Postpartal Psychosis

Postpartal Psychosis

A severe mental illness where a woman usually appears exceptionally sad. This condition exists when a person has lost contact with — and requires referral to a professional psychiatric counselor and antipsychotic medication.

reality