Postpartum Hemorrhage (PPH) - Nursing Notes
Definition
Postpartum hemorrhage (PPH) is excessive bleeding after delivery, defined as:
- >500 ml blood loss after vaginal delivery
- >1000 ml after cesarean section
Types
1. Primary (Early) PPH – within first 24 hours after birth
2. Secondary (Late) PPH – after 24 hours up to 6 weeks postpartum
Causes (4 T's)
1. Tone – Uterine atony (most common)
2. Tissue – Retained placenta or clots
3. Trauma – Perineal, vaginal, cervical tears
4. Thrombin – Coagulation disorders
Risk Factors
- Prolonged labor
- Overdistended uterus (multiple pregnancy, polyhydramnios)
- Induction or augmentation with oxytocin
- Previous history of PPH
- Anemia
Signs & Symptoms
- Heavy vaginal bleeding
- Low BP, high pulse
- Pale, cold skin
- Decreased urine output
Definition
Postpartum hemorrhage (PPH) is excessive bleeding after delivery, defined as:
- >500 ml blood loss after vaginal delivery
- >1000 ml after cesarean section
Types
1. Primary (Early) PPH – within first 24 hours after birth
2. Secondary (Late) PPH – after 24 hours up to 6 weeks postpartum
Causes (4 T's)
1. Tone – Uterine atony (most common)
2. Tissue – Retained placenta or clots
3. Trauma – Perineal, vaginal, cervical tears
4. Thrombin – Coagulation disorders
Risk Factors
- Prolonged labor
- Overdistended uterus (multiple pregnancy, polyhydramnios)
- Induction or augmentation with oxytocin
- Previous history of PPH
- Anemia
Signs & Symptoms
- Heavy vaginal bleeding
- Low BP, high pulse
- Pale, cold skin
- Decreased urine output
