During a consultation, your doctor will use various techniques in his assesment of the symptom: Postpartum hemorrhage. These may include a physical examination or other medical tests. Your doctor may ask several questions when assessing your condition. It is important to remember that your consultation is a two-way process and any extra information you can share with your doctor may help them with their diagnosis.
Some of the questions your doctor may ask are listed below:
Why: Primary postpartum hemorrhage occurs within 24 hours after the delivery. Secondary postpartum hemorrhage occurs between 24 hours and six weeks after the delivery of the baby.
Why: e.g. postpartum hemorrhage indicates that the vaginal blood loss is greater than 500ml.
Why: e.g. there is an increased risk of postpartum hemorrhage with prolonged labour, obstructed labour, forceps delivery, attempted vaginal birth after a caesarian section (VBAC), inverted uterus, having given birth to more than 5 babies in the past, the presence of excessive amounts of amniotic fluid during pregnancy, multiple pregnancies such as twins or triplets, large baby, vaginal hemorrhage during the pregnancy due to either placental abruption or placenta praevia; placental abruption, amniotic fluid embolus, intrauterine fetal death increases the risk of subsequent coagulation/clotting defects.
Why: e.g. syntometrine intramuscular injection stimulates the contraction of the uterus and helps reduce the rate of postpartum hemorrhage.
Why: Retained products of conception and retained placenta is a common cause of postpartum hemorrhage.
Why: "Rubbing up" the uterus stimulates contraction of the uterus and reduces the risk of postpartum hemorrhage.
Why: lacerations or tears may be the cause of primary postpartum hemorrhage.
Why: e.g. there is an increased risk of postpartum hemorrhage if there is a history of previous postpartum hemorrhage or previous manual removal of placenta in an earlier pregnancy.
Why: e.g. fibroids (benign tumors in the uterus) increase the risk of postpartum hemorrhage.
Why: e.g. anesthesia with ether or halothane during delivery may increase the risk of postpartum hemorrhage; uterine relaxing agents such as ritodrine and terbutaline increase the risk of postpartum hemorrhage.
Sometimes, other symptoms may be present and may help your doctor analyse your condition. These may include:
Why: purpura ( multiple small hemorrhages into the skin or mucous membranes); petechiae (small pinhead size purpura); ecchymoses ( large purpura) - May indicate a bleeding disorder.
Why: may indicate endometritis (infection of the lining of the uterus) which may cause secondary postpartum hemorrhage.
Why: may indicate endometritis (infection of the lining of the uterus) which may cause secondary postpartum hemorrhage.
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