Complications of Postpartum Hemorrhage After Delivery

The time leading up to having your baby is usually full of excitement, planning, and joy. Welcoming a new member into your family is a momentous occasion and for most families, a smooth process. There are, however, many life-threatening complications that can occur in vaginal and cesarean deliveries that can leave a family devastated instead of celebrating. One such complication is postpartum hemorrhage (PPH). A mother is considered to have postpartum hemorrhaging when there is more bleeding than normal after the birth of her baby. Between one to five women out of each hundred who give birth experience postpartum hemorrhaging.

Causes of Postpartum Hemorrhage

After a baby has been delivered, the woman’s uterus typically contracts and pushes out the placenta. Once the placenta has been delivered, uterine contractions help keep pressure on blood vessels where the placenta was attached, like putting pressure on an open wound. Without enough pressure from the contractions, the blood vessels can bleed freely which causes postpartum hemorrhage. To be clinically diagnosed, postpartum hemorrhage requires a loss of over 500 cc of blood after a vaginal delivery or 1000 cc of blood after a cesarean delivery.

Other common causes include:

• Rips or tears in the cervix or vaginal tissue
• Tears in uterine blood vessels
• Blood clotting disorders (may not have previously been diagnosed)
• Placenta detachment issues
• Bleeding into hidden tissue leading to hematomas

Postpartum hemorrhage, unfortunately, has deep roots tied to medical malpractice. A variety of tools and medications are used during childbirth and some can cause excessive bleeding if not used properly. The use of forceps, vacuum extraction, the medication Pitocin, or medical issues that were not diagnosed before birth can all cause hemorrhaging. If the postpartum hemorrhaging occurred naturally, without the doctor’s misuse of medication or tools, that doctor still has a duty of care to promptly diagnose and treat the source of bleeding. Any delay in diagnosis can lead to serious consequences, including hypoxia, organ failure, brain damage, shock, and death.

There are many tell-tale symptoms of postpartum hemorrhage that a doctor is trained to quickly identify, including uncontrolled bleeding, a decrease in blood pressure, elevated heart rate, low red blood cell count, and swelling and pain in the vagina. If you have been discharged from the hospital but find the symptoms you are experiencing match those listed, call your doctor immediately. You must be diagnosed and treated quickly to prevent permanent damage. Your doctor should do a physical exam and lab tests to determine if you are experiencing postpartum hemorrhage.

Treatment of Postpartum Hemorrhage

Like any external wound, the key to treating a postpartum hemorrhage is to find and stop the source of the bleeding as quickly as possible. Common treatments include:

• A full uterine exam and examination of other pelvic tissues, the vagina, and vulva to find any missed tears
• Providing medication or uterine massage to simulate contractions
• Finding and removing pieces of the placenta that remain in the uterus after birth
• Inserting a Foley Catheter or Bakri balloon to put pressure on the bleeding in the uterus
• Packing the uterus with sterile sponges and other materials to help stop the bleeding
• Laparotomy – a surgical procedure that opens the abdomen to find the source of the bleeding if other methods have failed
• Tying off or sealing bleeding blood vessels during the laparotomy
• Hysterectomy – a surgical procedure to completely remove the uterus, used as an absolute last resort

In all treatments, replacing lost blood and fluids is essential to the mother’s full recovery. Providing intravenous fluids (IV), blood, and medications can prevent shock and death. Oxygen may also be provided.

Can Postpartum Hemorrhage Be Prevented?

Preventing postpartum hemorrhage is critical to ensuring a mother can fully and safely recover after birth and enjoy spending time with her new baby. Doctors should work together with the mother to identify any risk factors present that would make PPH more likely to occur during childbirth, including:

• A delivery that is assisted by medical tools including forceps or a vacuum
• A baby that is larger in size
• Excess amniotic fluid
• A previous history of PPH
• Labor inducing medications
• Multiple births
• PPH during previous births
• Prolonged third stage of labor or delivery of the placenta

Preparation for postpartum hemorrhage to occur in high-risk patients includes preparing the delivery room with special medications and equipment ready to use at a moment’s notice. Your doctor is responsible for knowing what risks may be present during the birth of your child. Any negligence on their part in failing to prepare is unacceptable – and a deviation from the standard of care required of medical professionals under the law.

Philadelphia Medical Malpractice Attorneys

After childbirth, you should be focused on caring for your baby, not worrying about life-threatening birth complications. If a trusted medical professional made a mistake during childbirth, the mother can suffer serious medical complications that can lead to catastrophic injury or even death. When handled correctly, the compensation for your injuries should allow you to recovery fully and continue to take care of your child. If you or someone you know has dealt with medical malpractice during childbirth, contact the experienced trial attorneys of Lopez McHugh today.