Postpartum hemorrhage is defined as the loss of 500ml or more of blood from the reproductive tract after the third stage of labor. The usually guoted incidence of postpartum hemorrhage is 4-8%.
Hemorrhage is the third leading cause of maternal mortality and is directly responsible for about one-sixth of maternal deaths in the United States, and 22% or more of direct maternal deaths is caused by hemorrhage in Koirea.
Causes of postpartum hemorrhage include uterine atony, obstetric lacerations, retained placental tissue, and coagulation defects. Of these, uterine atony, lacerations, and retained placental fragments account for over 90% of cases of postpartum
hemorrhage.
Although the overall maternal mortality rate has declined sharply, hemorrhagic death associated with childbirth is still a major obstetrical problem. This is not because of inadequate facilities or difficulty in transportation, but rather because
of
failure of anticipation and/or early recognition of excessive bleeding.
It is better to avoid postpartum hemorrhage than to have to treat it. All patients in labor should be evaluated for risk of hemorrhage. Anticipation of the excessive bleeding, prompt recognition, exact estimation of the blood loss, and proper
management
are all associated with decreasing postpartum hemorrhage-related maternal death.
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