Options
Rename Topic
Delete Topic
Are you sure you want to delete this topic?
Shared by Zenith Health
What made this response need improvement?
What is PPH in pregnancy?
Penny found 20 sources
with relevant information
6 peer-reviewed research articles
2 professionally-backed sources
3 articles from healthcare institutions
Overview
PPH stands for postpartum hemorrhage, which is a serious complication involving excessive bleeding after childbirth. It is one of the leading causes of maternal illness and death worldwide, but with prompt recognition and treatment, most people recover well.
What Is PPH?
Definition
-
Postpartum hemorrhage (PPH) is defined as blood loss greater than 500 milliliters (mL) after a vaginal birth or more than 1,000 mL after a cesarean birth. However, the diagnosis can also be based on symptoms of blood loss, such as low blood pressure, rapid heartbeat, or signs of shock, since blood loss can sometimes be underestimated or hidden by normal pregnancy changes.
Introduction - Management of Postpartum Hemorrhage - NCBI BookshelfPostpartum hemorrhage (PPH) is commonly defined as blood loss exceeding 500 milliliters (mL) following vaginal birth and 1000 mL following cesarean.1 Definitions vary, however, and diagnosis of PPH is subjective and often based on inaccurate estimates of blood loss.1-4 Moreover, average blood ...Postpartum Hemorrhage: Overview, Etiology, DiagnosisAcquired coagulopathies during ... fluid embolism, or sepsis. ... ACOG defines primary PPH as a cumulative blood loss of at least 1 liter or any bleeding with signs of hypovolemia within 24 hours after delivery, although worldwide definitions may vary....Read full articleSource: MedscapePostpartum Hemorrhage | Children's Hospital of PhiladelphiaPostpartum hemorrhage is excessive bleeding after the birth of a baby. Most postpartum hemorrhage occurs right after delivery, but it can occur later as well.Management of Postpartum Haemorrhage - PMCDespite number of contributing ... of PPH, pregnancy-induced hypertension, chorioamnionitis, episiotomy, pre-labour caesarean section, macrosomia, and operative vaginal delivery), PPH can develop unpredictably without any risk factor.2 Therefore, any maternal unit should be prepared to managePPH with ...Read full articleSource: PubMed Central
- PPH is classified as:
- Primary (early) PPH: Occurs within 24 hours after delivery.
-
Secondary (late) PPH: Occurs from 24 hours up to 12 weeks postpartum.
Introduction - Management of Postpartum Hemorrhage - NCBI BookshelfPostpartum hemorrhage (PPH) is commonly defined as blood loss exceeding 500 milliliters (mL) following vaginal birth and 1000 mL following cesarean.1 Definitions vary, however, and diagnosis of PPH is subjective and often based on inaccurate estimates of blood loss.1-4 Moreover, average blood ...Postpartum Hemorrhage: Overview, Etiology, DiagnosisAcquired coagulopathies during ... fluid embolism, or sepsis. ... ACOG defines primary PPH as a cumulative blood loss of at least 1 liter or any bleeding with signs of hypovolemia within 24 hours after delivery, although worldwide definitions may vary....Read full articleSource: MedscapeManagement of Postpartum Haemorrhage - PMCDespite number of contributing ... of PPH, pregnancy-induced hypertension, chorioamnionitis, episiotomy, pre-labour caesarean section, macrosomia, and operative vaginal delivery), PPH can develop unpredictably without any risk factor.2 Therefore, any maternal unit should be prepared to managePPH with ...Read full articleSource: PubMed Central
Causes and Risk Factors
Main Causes (The "Four T's")
- Tone: Uterine atony (the uterus does not contract well), which is the most common cause.
- Trauma: Injury to the birth canal, such as tears or lacerations.
- Tissue: Retained placenta or blood clots.
-
Thrombin: Problems with blood clotting (coagulation disorders).
Postpartum Hemorrhage: Overview, Etiology, DiagnosisAcquired coagulopathies during ... fluid embolism, or sepsis. ... ACOG defines primary PPH as a cumulative blood loss of at least 1 liter or any bleeding with signs of hypovolemia within 24 hours after delivery, although worldwide definitions may vary....Read full articleSource: MedscapePostpartum Hemorrhage - StatPearls - NCBI BookshelfPostpartum hemorrhage (PPH) poses a significant risk to maternal health and is characterized by excessive blood loss after delivery. While uterine contractions and the coagulation cascade primarily regulate blood loss, PPH can lead to severe complications if untreated.Management of Postpartum Haemorrhage - PMCDespite number of contributing ... of PPH, pregnancy-induced hypertension, chorioamnionitis, episiotomy, pre-labour caesarean section, macrosomia, and operative vaginal delivery), PPH can develop unpredictably without any risk factor.2 Therefore, any maternal unit should be prepared to managePPH with ...Read full articleSource: PubMed CentralEpidemiology and definition of PPH worldwide - ScienceDirectThe term “postpartum hemorrhage” ... of pregnancy and afterwards, therefore it is more precise to use the term “peripartum hemorrhage”. Postpartum/peripartum hemorrhage (PPH) is an obstetric emergency complicating 1–10% of all deliveries and is a leading cause of maternal mortality and morbidity worldwide. However, the incidence of PPH differs widely according to the definition and criteria ...Read full articleSource: sciencedirect.com
Risk Factors
- Some people have identifiable risk factors, such as:
- Multiple pregnancy (twins, triplets, etc.)
- Prolonged or rapid labor
- Large baby (macrosomia)
- Placenta previa or abruption (placenta issues)
- Previous history of PPH
- High blood pressure or preeclampsia
- Use of certain medications or assisted reproductive technologies
- Cesarean or operative vaginal delivery (forceps/vacuum)
- Blood clotting disorders
-
However, up to 40% of PPH cases occur in people with no known risk factors.
Management of Postpartum Haemorrhage - PMCDespite number of contributing ... of PPH, pregnancy-induced hypertension, chorioamnionitis, episiotomy, pre-labour caesarean section, macrosomia, and operative vaginal delivery), PPH can develop unpredictably without any risk factor.2 Therefore, any maternal unit should be prepared to managePPH with ...Read full articleSource: PubMed CentralPostpartum Hemorrhage (PPH): Causes, Risks & TreatmentBleeding excessively after giving birth can be scary and traumatic. You probably didn’t expect your birth experience to go this way. It’s important to share any concerns about excessive bleeding after delivery with your pregnancy care provider so they can identify signs of PPH as soon as ...Read full articleSource: Cleveland ClinicPostpartum Hemorrhage - Stanford Medicine Children's HealthPostpartum hemorrhage is more bleeding than normal after the birth of a baby. About 1 in 100 to 5 in 100 women have postpartum hemorrhage. It is more likely with a cesarean birth. It most often happens after the placenta is delivered, but it can also happen later.Risk factors for severe postpartum hemorrhage: a case-control study | BMC Pregnancy and Childbirth | Full TextSeveral risk factors for PPH are known, such as multiple pregnancy, operative delivery and chorionamnionitis, however PPH may occur among patients with no known risk factors [13, 14]. Our ability to reduce the risk of PPH depends on ongoing investigations of previously unaccounted for causes and ...Read full articleSource: BioMed CentralIncidence and risk factors for postpartum hemorrhage among transvaginal deliveries at a tertiary perinatal medical facility in Japan - PMCRisk factors include antepartum ... magnitude and risk factors for PPH. Common causes include uterine atony, trauma including genital tract injuries, placental retentions and failure of the blood coagulation system....Read full articleSource: PubMed Central
Why Is PPH Important?
-
Prevalence: PPH affects about 1–10% of all deliveries, with severe cases in about 1–2% of births.
Management of Postpartum Haemorrhage - PMCDespite number of contributing ... of PPH, pregnancy-induced hypertension, chorioamnionitis, episiotomy, pre-labour caesarean section, macrosomia, and operative vaginal delivery), PPH can develop unpredictably without any risk factor.2 Therefore, any maternal unit should be prepared to managePPH with ...Read full articleSource: PubMed CentralEpidemiology and definition of PPH worldwide - ScienceDirectThe term “postpartum hemorrhage” ... of pregnancy and afterwards, therefore it is more precise to use the term “peripartum hemorrhage”. Postpartum/peripartum hemorrhage (PPH) is an obstetric emergency complicating 1–10% of all deliveries and is a leading cause of maternal mortality and morbidity worldwide. However, the incidence of PPH differs widely according to the definition and criteria ...Read full articleSource: sciencedirect.com
-
Impact: It is a leading cause of maternal death globally, responsible for about a quarter of all maternal deaths. Most deaths are considered preventable with timely recognition and treatment.
Introduction - Management of Postpartum Hemorrhage - NCBI BookshelfPostpartum hemorrhage (PPH) is commonly defined as blood loss exceeding 500 milliliters (mL) following vaginal birth and 1000 mL following cesarean.1 Definitions vary, however, and diagnosis of PPH is subjective and often based on inaccurate estimates of blood loss.1-4 Moreover, average blood ...Sexual and Reproductive Health and Research (SRH)Severe bleeding after childbirth - postpartum haemorrhage (PPH) - is the leading cause of maternal mortality world-wide.Read full articleSource: who.intEpidemiology and definition of PPH worldwide - ScienceDirectThe term “postpartum hemorrhage” ... of pregnancy and afterwards, therefore it is more precise to use the term “peripartum hemorrhage”. Postpartum/peripartum hemorrhage (PPH) is an obstetric emergency complicating 1–10% of all deliveries and is a leading cause of maternal mortality and morbidity worldwide. However, the incidence of PPH differs widely according to the definition and criteria ...Read full articleSource: sciencedirect.com
-
Complications: If not managed quickly, PPH can lead to shock, organ failure, need for blood transfusion, surgery (including hysterectomy), and longer hospital stays.
Introduction - Management of Postpartum Hemorrhage - NCBI BookshelfPostpartum hemorrhage (PPH) is commonly defined as blood loss exceeding 500 milliliters (mL) following vaginal birth and 1000 mL following cesarean.1 Definitions vary, however, and diagnosis of PPH is subjective and often based on inaccurate estimates of blood loss.1-4 Moreover, average blood ...Management of Postpartum Haemorrhage - PMCDespite number of contributing ... of PPH, pregnancy-induced hypertension, chorioamnionitis, episiotomy, pre-labour caesarean section, macrosomia, and operative vaginal delivery), PPH can develop unpredictably without any risk factor.2 Therefore, any maternal unit should be prepared to managePPH with ...Read full articleSource: PubMed Central
Summary
PPH is excessive bleeding after childbirth and is a major cause of maternal health complications. It can happen to anyone after delivery, even without risk factors. The most common cause is the uterus not contracting well after birth, but other causes include trauma, retained tissue, and clotting problems. Prompt medical attention and treatment are critical for a good outcome.
Introduction - Management of Postpartum Hemorrhage - NCBI Bookshelf
Postpartum hemorrhage (PPH) is commonly defined as blood loss exceeding 500 milliliters (mL) following vaginal birth and 1000 mL following cesarean.1 Definitions vary, however, and diagnosis of PPH is subjective and often based on inaccurate estimates of blood loss.1-4 Moreover, average blood ...
Postpartum Hemorrhage - StatPearls - NCBI Bookshelf
Postpartum hemorrhage (PPH) poses a significant risk to maternal health and is characterized by excessive blood loss after delivery. While uterine contractions and the coagulation cascade primarily regulate blood loss, PPH can lead to severe complications if untreated.
Postpartum Hemorrhage: Overview, Etiology, Diagnosis
Acquired coagulopathies during ... fluid embolism, or sepsis. ... ACOG defines primary PPH as a cumulative blood loss of at least 1 liter or any bleeding with signs of hypovolemia within 24 hours after delivery, although worldwide definitions may vary....
Read full article
Source:
Medscape
Management of Postpartum Haemorrhage - PMC
Despite number of contributing ... of PPH, pregnancy-induced hypertension, chorioamnionitis, episiotomy, pre-labour caesarean section, macrosomia, and operative vaginal delivery), PPH can develop unpredictably without any risk factor.2 Therefore, any maternal unit should be prepared to managePPH with ...
Read full article
Source:
PubMed Central
Epidemiology and definition of PPH worldwide - ScienceDirect
The term “postpartum hemorrhage” ... of pregnancy and afterwards, therefore it is more precise to use the term “peripartum hemorrhage”. Postpartum/peripartum hemorrhage (PPH) is an obstetric emergency complicating 1–10% of all deliveries and is a leading cause of maternal mortality and morbidity worldwide. However, the incidence of PPH differs widely according to the definition and criteria ...
Read full article
Source:
sciencedirect.com
Postpartum Hemorrhage (PPH): Causes, Risks & Treatment
Bleeding excessively after giving birth can be scary and traumatic. You probably didn’t expect your birth experience to go this way. It’s important to share any concerns about excessive bleeding after delivery with your pregnancy care provider so they can identify signs of PPH as soon as ...
Read full article
Source:
Cleveland Clinic
If you have more questions about PPH, its risk factors, or what to expect if it occurs, I can provide more detailed information.
Providing feedback helps us improve Penny's responses.
Peer-Reviewed Research
Published, peer-reviewed scientific studies from journals or databases.
1
Introduction - Management of Postpartum Hemorrhage - NCBI Bookshelf
Postpartum hemorrhage (PPH) is commonly defined as blood loss exceeding 500 milliliters (mL) following vaginal birth and 1000 mL following cesarean.1 Definitions vary, however, and diagnosis of PPH is subjective and often based on inaccurate estimates of blood loss.1-4 Moreover, average blood ...
4
Management of Postpartum Haemorrhage - PMC
Despite number of contributing ... of PPH, pregnancy-induced hypertension, chorioamnionitis, episiotomy, pre-labour caesarean section, macrosomia, and operative vaginal delivery), PPH can develop unpredictably without any risk factor.2 Therefore, any maternal unit should be prepared to managePPH with ...
Read full article
Source:
PubMed Central
5
Postpartum Hemorrhage - StatPearls - NCBI Bookshelf
Postpartum hemorrhage (PPH) poses a significant risk to maternal health and is characterized by excessive blood loss after delivery. While uterine contractions and the coagulation cascade primarily regulate blood loss, PPH can lead to severe complications if untreated.
6
Epidemiology and definition of PPH worldwide - ScienceDirect
The term “postpartum hemorrhage” ... of pregnancy and afterwards, therefore it is more precise to use the term “peripartum hemorrhage”. Postpartum/peripartum hemorrhage (PPH) is an obstetric emergency complicating 1–10% of all deliveries and is a leading cause of maternal mortality and morbidity worldwide. However, the incidence of PPH differs widely according to the definition and criteria ...
Read full article
Source:
sciencedirect.com
9
Risk factors for severe postpartum hemorrhage: a case-control study | BMC Pregnancy and Childbirth | Full Text
Several risk factors for PPH are known, such as multiple pregnancy, operative delivery and chorionamnionitis, however PPH may occur among patients with no known risk factors [13, 14]. Our ability to reduce the risk of PPH depends on ongoing investigations of previously unaccounted for causes and ...
Read full article
Source:
BioMed Central
10
Incidence and risk factors for postpartum hemorrhage among transvaginal deliveries at a tertiary perinatal medical facility in Japan - PMC
Risk factors include antepartum ... magnitude and risk factors for PPH. Common causes include uterine atony, trauma including genital tract injuries, placental retentions and failure of the blood coagulation system....
Read full article
Source:
PubMed Central
Causes of and risk factors for postpartum haemorrhage: a systematic review and meta-analysis - The Lancet
Acute obstetric coagulopathy during postpartumhemorrhage is caused by hyperfibrinolysis and dysfibrinogenemia: an observational cohort study · J Thromb Haemost. 2023; 21:862-879 ... Stachetti, T ∙ Spodenkiewicz, M ∙ Winer, A ∙ et al. Factors associated with severe postpartum haemorrhage: systematic review using Bradford Hill's causality framework · J Glob Health Rep. 2019; 3, e2019085 ... Regan, AK ∙ Arah, OA ∙ Fell, DB ∙ et al. SARS-CoV-2 infection during pregnancy ...
Read full article
Source:
The Lancet
Outcomes of pregnancy following postpartum haemorrhage - PubMed
From this cohort study we can conclude that if a PPH occurs in a first pregnancy, there is no delay in achieving a second pregnancy, and no detrimental effect on the outcome of that pregnancy. Significantly fewer women conceive a second pregnancy if they have a caesarean section in their first ...
Read full article
Source:
PubMed
Postpartum haemorrhage (PPH) rates in randomized trials of PPH prophylactic interventions and the effect of underlying participant PPH risk: a meta-analysis | BMC Pregnancy and Childbirth | Full Text
Low risk studies were those which ... multiple pregnancy, previous PPH, preeclampsia, fibroids, polyhydramnios, intrauterine foetal demise, antepartum haemorrhage and placenta praevia/accreta (for caesarean section only). Table 2 Grading system for trials of intervention for PPH prophylaxis, based on participant inclusion criteria ... The primary outcome was the average ...
Read full article
Source:
BioMed Central
Factors Affecting the Risk of Postpartum Hemorrhage in Pregnant Women in Tibet Health Facilities - PMC
Also, a higher risk of placenta ... a riskfactorforPPH, and this was supported by the results of several previous studies [25–28]. The present results showed that women with a history of preterm birth exhibited 1.66 times higher risk of having PPH than those without a history of preterm birth. The reason may be that women with preterm deliveries often have pregnancy complications such as placenta previa and premature rupture of membranes, which cause endometrial ...
Read full article
Source:
PubMed Central
Prevalence and risk factors of severe postpartum hemorrhage: a retrospective cohort study | BMC Pregnancy and Childbirth | Full Text
Management of PPH in our center ... during pregnancy, detailed information about delivery and complications occurring intrapartum or postpartum and information about the newborns. Volume of PPH, transfusion information, modes of delivery, and various candidate riskfactors were registered, ...
Read full article
Source:
BioMed Central
Clinical Guidelines & Professional Sources
Clinical recommendations from government, public health organizations, or professional medical provider associations.
2
Postpartum Hemorrhage: Overview, Etiology, Diagnosis
Acquired coagulopathies during ... fluid embolism, or sepsis. ... ACOG defines primary PPH as a cumulative blood loss of at least 1 liter or any bleeding with signs of hypovolemia within 24 hours after delivery, although worldwide definitions may vary....
Read full article
Source:
Medscape
11
Sexual and Reproductive Health and Research (SRH)
Severe bleeding after childbirth - postpartum haemorrhage (PPH) - is the leading cause of maternal mortality world-wide.
Read full article
Source:
who.int
Postpartum Hemorrhage: Prevention and Treatment | AAFP
Postpartum hemorrhage is common and can occur in patients without risk factors for hemorrhage. Active management of the third stage of labor should be used routinely to reduce its incidence. Use of oxytocin after delivery of the anterior shoulder is the most important and effective component ...
Management of Postpartum Hemorrhage | Effective Health Care (EHC) Program
Aortic compression is another compression technique that has been used for severe PPH.29,30 · The immediate postpartum period is a unique physiologic state with relative intravascular volume expansion with a reduction in cardiovascular demand compared to pregnancy.
Postpartum Hemorrhage | ACOG
ACOG uses cookies, pixels and similar technologies to personalize your website experience. By clicking “continue” or continuing to use our site, you agree to our Privacy Policy · By reading this page you agree to ACOG's Terms and Conditions. Read terms
Guideline on Prevention and Management of PPH 1 Introduction
Secondary PPH is defined as abnormal or excessive bleeding from the birth canal between 24 ... – Functional/anatomic distortion of uterus Rapid labour, prolonged labour, fibroids, placenta praevia, ... – Uterine relaxants, e.g. magnesium and nifedipine Terbutaline, halogenated anaesthetics, ...
Medical & Academic Institutions
Information from hospitals, research institutions, or academic medical centers known for clinical expertise and research contributions.
3
Postpartum Hemorrhage | Children's Hospital of Philadelphia
Postpartum hemorrhage is excessive bleeding after the birth of a baby. Most postpartum hemorrhage occurs right after delivery, but it can occur later as well.
7
Postpartum Hemorrhage (PPH): Causes, Risks & Treatment
Bleeding excessively after giving birth can be scary and traumatic. You probably didn’t expect your birth experience to go this way. It’s important to share any concerns about excessive bleeding after delivery with your pregnancy care provider so they can identify signs of PPH as soon as ...
Read full article
Source:
Cleveland Clinic
8
Postpartum Hemorrhage - Stanford Medicine Children's Health
Postpartum hemorrhage is more bleeding than normal after the birth of a baby. About 1 in 100 to 5 in 100 women have postpartum hemorrhage. It is more likely with a cesarean birth. It most often happens after the placenta is delivered, but it can also happen later.
General Health & Web Sources
Publicly available health-related articles from non-peer-reviewed sources. These may reference research or clinical guidelines, but are not primary sources.
Uncategorized Sources
Information from sources that have not yet been categorized.