How common is late postpartum hemorrhage?

How common is late postpartum hemorrhage?

PPH is characterized as early or late, depending on whether the bleeding occurs within 24 hours of delivery (early, or primary) or between 24 hours and 6 to 12 weeks postpartum (late, or secondary). Primary PPH occurs in 4% to 6% of pregnancies.

What is the most common cause of hypovolemic shock?

Hypovolemic shock is most often the result of blood loss after a major blood vessel bursts or from a serious injury. This is called hemorrhagic shock. You can also get it from heavy bleeding related to pregnancy, from burns, or even from severe vomiting and diarrhea.

What are the 4 stages of shock?

There are four stages of cardiogenic shock: initial, compensatory, progressive, and refractory. During the initial stage, there is diminished cardiac output without any clinical symptoms.

How do you stop a hemorrhage after giving birth?

Uterotonics (such as oxytocin and misoprostol) cause uterine contractions and have long been used to treat uterine atony and reduce the amount of blood lost following childbirth. Use of a uterotonic drug immediately after the delivery of the newborn is one of the most important interventions to prevent PPH.

Can dehydration cause hypovolemic shock?

This is one of the most serious, and sometimes life-threatening, complications of dehydration. It occurs when low blood volume causes a drop in blood pressure and a drop in the amount of oxygen in your body.

What are the stages of hypovolemic shock?

HYPOVOLEMIA refers to any condition in which the extracellular fluid volume is reduced, and results in decreased tissue perfusion. Salt + water loss comes primarily from the extracellular fluid whereas pure water loss (dehydration) come from the total body water, only about 1/3 of which is extracellular.

What does uterine Atony feel like?

What Are the Symptoms of Atony of the Uterus? The main symptom of atony of the uterus is a uterus that remains relaxed and without tension after giving birth. Atony of the uterus is one of the most common causes of postpartum hemorrhage.

What happens during hypovolemic shock?

Hypovolemic shock happens when a sudden and significant loss of blood or body fluids drops your blood volume. Blood helps to hold your body temperature steady, forms blood clots, and moves oxygen and nutrients to all of your body's cells. If your blood volume gets too low, your organs won't be able to keep working.

What type of shock may be caused by hemorrhage or dehydration?

While the incidence of hypovolemic shock from extracellular fluid loss is difficult to quantify, it is known that hemorrhagic shock is most commonly due to trauma. In one study, 62.2% of massive transfusions at a level 1 trauma center were due to traumatic injury.

What are the differences between early and late hemorrhage?

Also called late or delayed hemorrhage, secondary postpartum hemorrhage occurs between 24 hours and 6 weeks postpartum. In contrast, primary (early) postpartum hemorrhage occurs within the first 24 hours after delivery.

How is uterine Atony diagnosed?

Atony of the uterus is usually diagnosed when the uterus is soft and relaxed and there's excessive bleeding after giving birth. Your doctor may estimate the blood loss by counting the number of saturated pads or by weighing the sponges used to absorb blood.

When should I worry about postpartum bleeding?

Tell your doctor or call 911 if you have any of these symptoms or signs: Bright red bleeding beyond the third day after birth. Blood clots bigger than a plum. Bleeding that soaks more than one sanitary pad an hour and doesn't slow down or stop.

What labs indicate hypovolemia?

Initial laboratory studies should include analysis of the CBC, electrolyte levels (eg, Na, K, Cl, HCO3, BUN, creatinine, glucose levels), lactate, prothrombin time, activated partial thromboplastin time, ABGs, urinalysis (in patients with trauma), and a urine pregnancy test. Blood should be typed and cross-matched.

What causes PPH?

Causes. Causes of postpartum hemorrhage are uterine atony, trauma, retained placenta or placental abnormalities, and coagulopathy, commonly referred to as the "four Ts": Tone: uterine atony is the inability of the uterus to contract and may lead to continuous bleeding.