18 August, 2021

Postpartum hemorrhage (PPH)

Postpartum hemorrhage (PPH) is heavy bleeding after giving birth. It’s a serious but rare condition. It usually happens on first day of giving birth, but it can happen anytime upto 12 weeks after having a baby. Research shows upto 5 in 100 women who have a baby can land up in PPH.

Losing some blood is normal after giving birth. Women usually lose about 500 ml during vaginal birth or about 1,000 ml after a cesarean birth (also called c-section).  In PPH, Blood loss is much more leading to a dangerous situation. PPH can cause a severe alteration in the vitals. If not treated immediately, this will cause to shock and death. 


After delivery of baby, the uterus contracts pushing out the placenta. After the placenta is delivered, these contractions puts pressure on the bleeding vessels at the placental attachment site. If the uterus doesn’t contract strongly enough, these blood vessels bleed freely. Small pieces of the placenta attached can also lead to bleeding. 

Conditions that affect the uterus

  • Uterine atony. This is the foremost common cause of PPH. It is the condition when the muscles in your uterus remains relaxed after birth. It usually happens if uterus is stretched or enlarged from giving birth to twins or a large baby. It also can happen if you’ve already had several children, you’re in labor for a long time or you have too much amniotic fluid (fluid that surrounds your baby).
  • Uterine inversion. This is a rare condition when the uterus turns inside out after delivery of the baby with or without placenta.
  • Uterine rupture. This is when the uterus tears during the process of labor. It happens rarely. It may happen in cases of scared uterus from previous surgeries on the uterus. 

Conditions that affect the placenta

  • Placental abruption. Placenta separates partially or completely before birth.
  • Placenta accreta, placenta increta or placenta percreta- Placenta do not separate after delivery as it has grown deep into the uterine wall.
  • Placenta previa– Placenta lie over cervix in the lower segment of the uterus which do not contract after delivery.
  • Retained placenta- Placenta is not delivered within 30-60minutes of delivery. Sometimes even after placental delivery, a small part can be left in the uterus leading to PPH.

 Conditions during labor and birth

  • Having a c-section 
  • Getting general anesthesia. Usually needed only in cases of emergency c-section. It can cause uterine relaxation.
  • Taking medicines to induce labor.   
  • Taking medicines to stop or prevent preterm labor. If you have preterm labor, your doctor may give you medicines called tocolytics to slow or stop contractions.
  • Tearing (also called lacerations). This may happen if a part of vagina or cervix are cut or torn during birth. This can happen following birth of a large baby, your baby is born through the birth canal too quickly or you have an episiotomy that tears. Tearing also can happen if your doctor have to use forceps or a vacuum, to help move your baby through the birth canal during birth. 
  • A quick labor or prolong labor. Labor is different for every woman.  

Other conditions

  • Clotting disorders, like von Willebrand disease or disseminated intravascular coagulation (also called DIC). -can increase your risk of forming a hematoma. 
  • Infection, like chorioamnionitis.-infection of the placenta and amniotic fluid.
  • Intrahepatic cholestasis of pregnancy (also called ICP). It can alter clotting mechanism.
  • Obesity. 
  • Preeclampsia or gestational hypertension. These are conditions with high blood pressure in pregnant women. 


Each woman may experience symptoms differently but most common are:

  • uncontrolled bleeding
  • decreased blood pressure
  • increased heart rate
  • decrease in the red blood cell count.
  • swelling and pain in the vaginal and perineal area


Your doctor may use these tests to see if you have PPH or try to find the cause for PPH:

  • Blood tests for clotting factors.
  • Hematocrit – It checks the percent of your blood (called whole blood) that’s made up of red blood cells. Bleeding can cause a low hematocrit.
  • Blood loss measurement – To evaluate the blood loss, your doctor may weigh or count the number of pads and sponges used to soak up the blood. 
  • Pelvic exam – For tears and haematomas.
  • Physical exam – For your vitals.
  • Ultrasound to check for problems with the placenta or uterus. TREATMENT

It depends on what’s causing your bleeding. The aim is to find and stop the cause of the bleeding as soon as possible. It may include:

  • Getting fluids, medicine (like Pitocin) or having a blood transfusion – to maintain the blood volume lost in PPH.
  • Examination of the uterus and other pelvic tissues, the vagina, and the vulva to look for areas that may need repair
  • Bakri balloon or a Foley catheter to put pressure on the bleeding area inside the uterus. 
  • Surgery, like a hysterectomy or a laparotomy. It is the last resort when other treatments are not working. Laprotomy is needed to find out the cause of bleeding and hysterectomy is done when uterus fails to contract inspite of all measures or is torn beyond repair.  
  • Massaging the uterus by hand. Help to contract the uterus.
  • Getting oxygen by mask
  • Removing any remaining pieces of the placenta from the uterus.
  • Embolization of the blood vessels of the uterus. It’s used in special cases and may prevent a hysterectomy. 
  • Taking extra iron supplements along with a prenatal vitamin. 


Mild PPH can lead to anemia, but severe PPH can lead to serious consequences like shock or even Death.


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27 December, 2022

Tips for dealing with postpartum vaginal discharge

Lochia, or the vaginal discharge that a woman’s body produces following childbirth, is expected to last for a few days to weeks after delivery. After birth, the rapid flow of blood and mucus begins. For the first 2-3 days after birth, the bleeding will be severe and contain blood clots. However, after a few days, the flow will gradually decrease to spotting before stopping entirely. When the uterus recovers after a few weeks, the flow colour can change from dark red to brown, then yellowish-white. It’s an unavoidable and inevitable occurrence, and the only thing you can do is wait for it to end. It continues to decrease in volume before entirely ending. Here are a few essential tips to keep you prepared for this postpartum vaginal discharge.  Pile up with sanitary napkins and replace them regularly. You’ll need big pads with a lot of absorption potential in the first few days. Maintaining strict sanitation and keeping your private parts washed will help you prevent more postpartum infections. To keep away the infections, avoid having tampons or menstrual cups. Empty the bladder regularly, even if you don’t have the urge. This will relieve you.  Medications that thin the blood, such as aspirin and ibuprofen, should
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21 January, 2021

4 Quick Tips For Uterine Infections Post-Delivery

It is highly known that UTIs are common for women and are even more common in pregnant women. Since the developing foetus may place pressure on the bladder and urinary tract, UTIs are more common during pregnancy and persist even after pregnancy. Although UTIs are common, they have to be treated and prevented for a healthier pregnancy and post-delivery period. Leaving them might lead to higher complications during pregnancy, leading to an unstable period post-delivery.  Thus, here are four quick tips for handling uterine infections post-delivery.  Drinking plenty of water  Drinking a minimum of eight full glasses of water a day is essential to avoid or handle UTIs. Water dilutes urine present in the bladder and helps flush bacteria out of the urinary tract with ease. The more the water, the more the bacteria gets pumped out. Having a good amount of water is a quick and easy way to rejuvenate your body.  Emptying the bladder before urge rises  Holding back the quick urge to empty your bladder pressurises the nerves in your bladder. In cases when you hold the pressure for too long or make this routine often, the nerves in your bladder will be at risk and start losing efficiency. That is why it is always suggested to urinate frequently and empty the bladder
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17 November, 2022

Taking care of mental wellbeing during pregnancy

Pregnancy often is a happy and joyous phase to treasure and cherish. It brings a mix of feelings for you, and not all of them are good. Few thoughts might even trigger the mental health that might disturb you so much during and after the pregnancy. It’s just as important to look at your mental wellbeing and health during pregnancy as your physical health.  For your safe and happy pregnancy, a happy lifestyle is crucial. However, it is good to notice your mood drifts to identify the problems in the early stages.  What can you usually experience?  While mood swings are common during pregnancy, continuous and long down moments are not good. Take a look at the durations you are down.  Feeling fear or anxiety all the time about your baby or pregnancy.  Having negative thoughts about your life, pregnancy and relation  Feeling burdened with unknown pressure in your mind can relate to the stress of pregnancy but requires attention.  Common mental problems experienced during pregnancy  Depression during Pregnancy “During pregnancy, the symptoms of depression such as changes in sleep, appetite, and energy levels are often difficult to distinguish from the regular experiences of pregnancy.“ says Diana Carter, MBBS Xanthoula Kostaras, BSc. In her recent publication, she mentioned that up to 70% of women report
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