November 11, 2020

Take Home Points
  • Watch for continued bleeding in excess of 500 ml or bleeding that is “more than normal.” Call it postpartum hemorrhage and start resuscitation
  • Call your obstetric and/or surgical consultants early as operative intervention is often required
  • Replace intravascular volume with blood products
  • Uterine atony is the most common cause of postpartum hemorrhage. Begin treatment with uterine massage and uterotonic medications
  • Consider the development in DIC when patients continue to bleed despite appropriate management

January 15, 2018

Definition: Blood loss > 500 ml after a delivery (or > 250 ml after an abortion). The management of post-abortion hemorrhage is similar to that of post-partum hemorrhage (PPH).

Causes

  • Uterine atony (~ 50% of cases)
  • Retained products of conception (POCs)
  • Cervical lacerations
  • Uterine perforation
  • Uterine Inversion
  • Abnormal placentation (accreta, increta, percreta)
  • Coagulopathy

Background:

  • Occurs in 1-2% of patients undergoing a first trimester surgical abortion
  • Most common cause of abortion-related mortally in 2nd trimester
  • Risk increases with increasing maternal age
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