Bleeding after birth

Bleeding after birth – definition

Postpartum bleeding is one of the complications of both a natural birth and a caesarean section. Perinatal haemorrhage is defined as blood loss of 500 ml within 24 hours after a natural birth and 1000 ml after a caesarean section. However, there are different definitions of haemorrhage. A falling haemoglobin and haematocrit value should also be noted.

What are the causes of bleeding after birth?

The main causes of perinatal bleeding include problems associated with uterine atony (i.e. when the uterus does not contract properly after birth), placental tissue remaining in the uterus, injuries to the cervix, vagina or perineum, and various types of coagulopathies (blood clotting disorders).

There is a higher risk of bleeding in patients with polycystic disease, obesity or uterine fibroids, as well as in multiple pregnancies.

How do you deal with bleeding after birth?

To prevent bleeding after the birth of the child, drugs such as oxytocin or carbetocin are used to contract the uterus properly. If there are risk factors for haemorrhage, such as multiple pregnancy, fetal macrosomia and uterine atony in a previous birth, carbetocin is used instead of oxytocin.

In the event of postpartum haemorrhage, medical staff have established routines such as searching for the cause of the excessive bleeding or administering medication to stop the bleeding. Such a situation often requires quick decisions to minimise blood loss. The occurrence of haemorrhage often also requires the transfusion of red blood cell concentrate and plasma to counteract the effects of the blood loss.