Postpartum haemorrhage or Excessive bleeding after delivery

"Postpartum haemorrhage. It is still considered normal after the placenta delivery up to 500 ml. If bleeding is more than 500 mL, it is really serious and needs immediate intervention because it can cause severe shock and death. What are the causes of postpartum haemorrhage? The most common cause is defective uterine contractility. The uterus has to contract after the delivery of the placenta, which does not do that. The most common other causes are there could be cervical or vaginal tears or there could be bleeding disorders in the patient. So, what are the risk factors for postpartum haemorrhage? Whenever there are multiple pregnancies like twins wherever, there is a uterine distension, which happens in twins, which happens in excessive liquor, and which happens even in big babies. Whenever there are placental issues, whenever there are infections, whenever there is a prolonged labour. So these are the few conditions with risk factors where postpartum haemorrhage can happen. So how do we treat it? Antenatally, patients have to take iron supplements and make sure the haemoglobin is always above the normal level. 11 is considered to be the lower limit of normal. So, always above 11 or at least 12 is considered fine. And the second thing is if there are any bleeding disorders which are diagnosed in the patient or in the family, it has to be intimated to the doctor. When Postpartum Hemorrhage has been diagnosed in the OT. The whole team is being alerted. So, all management measures are done simultaneously. One person arranges for blood; one person starts another IV line. The patient is given oxygen and IV fluids. At the vaginal end doctor empties the bladder and checks the cause of any tears are there so that they can be sutured. Then, as I said, the most common cause is defective uterine contractility. The bimanual compression method and massage are done to contract the uterus, and simultaneously, there are a few medications, prostaglandins or ergot alkaloids, used to contract the uterus. If all the medical measures fail"