Postpartum Hemorrhage: Causes and Types

Postpartum Hemorrhage

• Defined as excessive blood loss during or after the 3rd stage of labor (>500 ml)
• Types: Early (primary) - within the first 24 hours after delivery
• Late (secondary) - >24 hours after delivery up to 6 weeks postpartum
• Causes:
  • Uterine atony (most common)
  • Lower genital tract lacerations
  • Retained products of conception (Placenta accreta)
  • Uterine rupture
  • Uterine inversion
  • Hematoma

Puerperal Pyrexia

• Defined as:
  • Temperature >38.7oC during the first 24 hours after delivery
  • Temperature >38oC on any 2 days up to 10 days after delivery
• Causes:
  • Benign fever (resolution within 1st 24 hours)
  • Breast engorgement (most common cause)
  • Puerperal sepsis (most dangerous cause)
  • Urinary tract infection
  • Deep Venous Thrombosis (DVT)
  • Respiratory tract infection

Breast Engorgement

• Cause: Milk production > infant consumption
• Common 3-5 days postpartum
• Fever >38.5oC (usually lasts a few days)