Postpartum Hemorrhage

Postpartum hemorrhage (PPH) is excessive bleeding after delivery — more than 500 mL for vaginal birth or 1000 mL for cesarean. It is a leading cause of maternal death worldwide and requires immediate intervention.

Table of Contents

Quick Facts

  • ICD-10: O72
  • Severity: Life-threatening

Emergency

Any heavy bleeding after delivery is an emergency. Seek immediate care for soaking through a pad in less than an hour, passing large clots, dizziness, fainting, or rapid heartbeat.

Causes (the '4 Ts')

  • Tone — uterine atony (most common cause)
  • Trauma — perineal/vaginal/cervical tears
  • Tissue — retained placenta
  • Thrombin — coagulation disorders

Treatment

  • Uterine massage
  • Uterotonic medications (oxytocin, methylergonovine, misoprostol, carboprost)
  • Tranexamic acid
  • Manual removal of retained placenta
  • Repair of lacerations
  • Uterine balloon tamponade
  • Surgical interventions (uterine artery ligation, hysterectomy)
  • Massive transfusion protocols

Related Conditions

HELLP Syndrome

Related obstetric emergency

 Hemorrhagic Shock

Possible consequence
Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition. If you are experiencing a medical emergency, call your local emergency number immediately.

References

  • ACOG. Postpartum Hemorrhage Practice Bulletin.