Postpartum hemorrhage (PPH) refers to uterine bleeding after delivery and remains one of the major worldwide causes of maternal mortality.
A postpartum hemorrhage can be board classified as primary or secondary.
Primary postpartum hemorrhage
This is the most common form of major obstetric hemorrhage. The traditional definition of primary postpartum hemorrhage is the loss of 500 ml or more of blood from the genital tract within 24 hours of the birth of a baby. It can be minor (500-1000 ml) or major (more than 1000 ml). Major could be divided to moderate (1000-2000 ml) or severe (more than 2000 ml).
Secondary postpartum hemorrhage
Secondary postpartum hemorrhage is defined as abnormal or excessive bleeding from the birth canal between 24 hours and 12 weeks postnatally.
Causes: risk factors
- women with pre-existing bleeding disorders
- women taking therapeutic anticoagulants
- abnormal variation in placental villous adherence: placenta accreta spectrum
- abnormal variation in placental position: placenta previa spectrum
- excessive uterine relaxation
- retained placental components: retained products of conception
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