Postpartum Hemorrhage (PPH): Causes, Risks & Treatment - eliteNurses consult.com

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Postpartum Hemorrhage (PPH): Causes, Risks & Treatment | Nursing Guide

Postpartum Hemorrhage (PPH): Causes, Risks & Treatment

A clear, practical guide for nursing students and healthcare providers

By Elite Nurses Consult • Updated:

🔍 What is PPH?

Postpartum Hemorrhage (PPH) is excessive bleeding after childbirth — typically defined as blood loss > 1 litre (33 fl oz). PPH commonly occurs within the first 24 hours after delivery but can happen up to 12 weeks postpartum. If uncontrolled, it can lead to hypovolemic shock and organ compromise.

⚠️ Types of PPH

  • Primary PPH: within 24 hours after delivery.
  • Secondary (Late) PPH: 24 hours to 12 weeks postpartum.

💡 Causes — The 4 Ts Mnemonic

  • Tone: Uterine atony (inadequate uterine contraction) — the most common cause.
  • Trauma: Tears of the cervix, vagina or uterus, or surgical injury.
  • Tissue: Retained placental tissue or fragments.
  • Thrombin: Coagulation/clotting disorders that impair hemostasis.

👩‍🍼 Who’s at higher risk?

Anyone can have PPH, but risk increases with:

  • Placental problems (previa, abruption, accreta)
  • Prolonged or very rapid labour
  • Multiple pregnancy or large baby (macrosomia)
  • Cesarean delivery or instrumental delivery (forceps/vacuum)
  • Use of uterotonic or tocolytic drugs, obesity, advanced maternal age
  • Preexisting clotting disorders or pregnancy-related coagulation issues

🩸 Warning signs to watch for

  • Heavy vaginal bleeding or passing large clots
  • Dizziness, fainting, blurred vision
  • Rapid heart rate or low blood pressure
  • Pale, clammy skin; shortness of breath
  • Pain or swelling in the perineal or abdominal area

Important: If these signs occur after discharge, contact a healthcare provider immediately or go to the emergency department.

🏥 Diagnosis & Management

Diagnosis is clinical — estimate blood loss, monitor vital signs, and run blood tests or ultrasound as needed. Management is urgent and cause-directed:

  • Uterine massage and uterotonic medications to promote contraction
  • Removal of retained placenta (manual or surgical)
  • Surgical repair of vaginal/cervical tears
  • Balloon tamponade or arterial ligation/embolization to control bleeding
  • IV fluids, blood transfusion, and oxygen as supportive care
  • Hysterectomy in rare, life-threatening cases when other measures fail

🌿 Recovery & Self-care

Recovery time varies. Practical self-care tips:

  • Rest and accept help — avoid heavy lifting and overexertion
  • Eat iron-rich foods and take iron supplements if prescribed
  • Stay well-hydrated
  • Monitor bleeding — if it worsens or doesn’t gradually reduce, seek care
  • Seek emotional support if the birth experience was traumatic

If you’re a nursing student or clinician and want this post adapted for social media (Twitter thread, Instagram carousel, or a printable one-page summary), reply and I’ll prepare it for you.

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