Effective Management Of Postpartum Haemorrhage Can Reduce Maternal Mortality

A Medical Doctor at the Department of Obstetrics and Gynecology, General Hospital, Ijede, Dr. Mariam Abiola has revealed that proper management of Postpartum Haemorrhage (PPH) can reduce maternal mortality and morbidity in women after childbirth.

Dr. Abiola disclosed this while speaking at the monthly Continuous Medical Education (CME) organised by the Hospital for members of staff, describing PPH as blood loss greater than 500mls following vaginal birth, blood loss greater than 1000ml following caesarian section, or any significant blood loss that causes haemodynamic instability during childbirth.

She informed that Postpartum Haemorrhage can be prevented by optimising the haemoglobin (blood) level during antenatal, giving active management of the third stage of labour by skilled birth attendants, ensuring routine inspection of placenta and membranes after childbirth and so on.

Dr. Abiola maintained that some of the predisposing risk factors for PPH include a previous history of PPH, high parity, prolonged labour, induced labour, the mismanagement of third stage labour, uterine fibroids, full bladder and infection amongst others.

Her words: “When a woman loses 15% of blood during childbirth, there are usually no signs and symptoms; when a woman loses blood of 20 – 25% of blood during childbirth, there is usually a reduction of capillary refill and pulse pressure, a drop in blood pressure but increased pulse rate and respiratory rate and so on”.

While noting that blood loss is usually underestimated by some health workers, the Doctor stated that studies have revealed that 32% of PPH is the most common cause of maternal death in Nigeria and 33% worldwide.

“The principles of management of PPH is to ensure that health care workers evaluate maternal condition correctly and resuscitate as may be necessary, replace significant blood loss, make a diagnosis of the cause of the bleeding and treat it effectively, and to make a transfer to the next level of care when necessary”, Abiola asserted.

She, therefore, urged all medical facilities to put adequate measures in place for the effective management of Postpartum Haemorrhage in order to save the lives of pregnant women during/after childbirth.

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