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Postpartum Hemorrhage

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The disorder known as postpartum hemorrhage (PPH) is characterized by severe bleeding after childbirth and may be fatal. It accounts for a sizable percentage of maternal deaths globally and is a major cause of maternal mortality, especially in environments with limited resources.PPH mostly comes in two flavors: primary and secondary. While secondary PPH happens between 24 hours and six weeks postpartum, primary PPH happens during the first 24 hours following delivery.Primary PPH can be caused by a number of things, including as difficulties from labor induction or augmentation, birth canal tears or lacerations, retained placental tissue, or uterine atony (the inability of the uterus to contract after childbirth). Retained placental pieces, infections, and uterine subinvolution—the uterus's delayed return to its non-pregnant size—are the main causes of secondary PPH. Multiparity (having several pregnancies), protracted or abrupt labor, macrosomia (having a large fetal size), placental anomalies, and a history of PPH are risk factors for PPH.Timely identification and treatment of PPH are essential to avoid serious consequences. Estimating blood loss, monitoring vital signs, and determining the underlying cause of bleeding are all included in the initial assessment. The goals of management techniques are to stop the bleeding, increase blood flow, and deal with the underlying cause.To encourage uterine contraction and lessen bleeding, popular therapies include uterine massage, uterotonic drugs (such oxytocin, misoprostol, or ergometrine), and mechanical compression (like bimanual compression or uterine packing). Surgical procedures including uterine artery embolization, balloon tamponade, or surgical blood vessel ligation may be required in cases of severe or refractory PPH. For women with PPH, supportive care is crucial to optimizing outcomes in addition to treating the bleeding right away. This entails giving blood transfusions when necessary, keeping an eye out for indicators of shock, and preserving hemodynamic stability with intravenous fluid resuscitation.Reducing the occurrence of PPH also requires the use of preventive interventions. This entails early identification of risk factors, adequate labor and delivery management, and active management of the third stage of labor (uterotonic medicine administration, controlled cord traction, and uterine massage).In conclusion, postpartum hemorrhage is a serious obstetric emergency that needs to be recognized right away and treated promptly in order to avoid serious consequences. Healthcare professionals can lessen the impact of PPH and enhance maternal outcomes by putting into practice appropriate management techniques and preventive measures.