Postpartum hemorrhage (PPH) is usually delineated as loss of blood above 500 mL after vaginal conception and 1000mL after delivery via cesarean. Despite the developments evident in obstetrics, PPH is responsible for mortality and morbidity globally (Ekin et al., 2015). As such, efforts have been aimed at the implementation of effective management and prevention procedures. Foremost, the focus on these approaches necessitates an inclination towards the risk factors that expose women to grave incidences as far as PPH is concerned. The basis for this change in direction is associated with the increased incidents related to the disorder in numerous countries (Ekin et al., 2015). Understanding such factors may prove instrumental in augmenting interventions and protocols for averting PPH.
Risk factors comprise elements or susceptibility of a person that enhances the probability of an illness or an injury. Regarding PPH, Ekin et al. (2015) argue that specific characteristics or vulnerabilities expose women to severe primary PPH in comparison to populaces that do not possess such factors. However, studies centered on these factors, particularly the etiological role that they assume in respect to PPH, are minimal and limit approaches aimed at preventing and responding to severe cases (Ekin et al., 2015). Nonetheless, the respective study manages to establish specific predictors that can be applied in forecasting whether particular women are exposed to severe PPH. Women with a history of delivery by cesarean, engaged in oxytocin-enhanced pregnancies, prolonged labors, and emergency cesarean birth are more susceptible to severe PPH.
Alternately, limitations that restrict prevention of PPH have also been based on variations surrounding the definition of PPH. Generally, PPH has been delineated as blood loss over 500 mL after normal birth and 1000 mL after cesarean birth (Wilcox et al., 2017). Regarding this definition, the levels vary for PPH and severe PPH at 3 to 6 percent and 0.5 to 1 percent respectively (Ekin et al., 2015). These variations largely contribute to the management of PPH aside from information gaps regarding risk factors that enhance causation among the female populace. Aside from relying on the aspects above, Wilcox et al., (2017) advocates for the application of the Signaling a Postpartum Hemorrhage Emergency (SAPHE) Mat for accurate PPH diagnosis. Using a SAPHE Mat may prove efficient in management due to enhanced visual approximation of blood loss.
The concentration on risk factors and interventions such as the SAPHE Mat is an imperative step in developing interventions for preventing and managing PPH. However, this is not sufficient due to the numerous risk factors that women are exposed to during delivery as well as variations surrounding blood loss. In this respect, it is essential to develop a protocol for managing PPH. Establishing a protocol in hospitals and obstetric clinics for women that surpass the 500-1000 mL is imperative because it may offer early interventions for diagnosing and managing cases of PPH (D’Alton et al., 2017). In fact, a standardized protocol will lead to the improvement of patient outcomes by assessing and observing PPH patients, informing and organizing a multifaceted group, and proposing treatment channels (D’Alton et al., 2017).
Postpartum hemorrhage is a key
causative factor of obstetric mortality and morbidity in countries across the
globe. Even though PPH is based on blood loss exceeding 500 mL and 1000 mL in
vaginal birth and cesarean delivery respectively, variations affect management
and prevention since normal deliveries tend to provide such estimations.
Nonetheless, understanding risk factors that assume an etiological responsibility
in causation as well as the application of measures such as the SAPHE Mat may
prove essential in managing cases that involve PPH. Lastly, the implementation
of standardized in-house protocols may constitute interventions that enhance
patient outcomes in the long-term.
D’Alton, M. E., Cohen, J. S., Weinstein, D. L., Dweck, M. F., & Kober, S. (2017). Best practices in the management and treatment of postpartum hemorrhage. Retrieved from http://www.contemporaryobgyn.net/article/best-practices-management-and-treatment-postpartum-hemorrhage.
Ekin, A., Gezer, C., Solmaz, U., Taner, C. E., Dogan, A., & Ozeren, M. (2015). Predictors of severity in primary postpartum hemorrhage. Archives of Gynecology and Obstetrics, 292, 1247-1254.
Wilcox, L., Ramprasad, C., Gutierrez, A., Oden, M., Richards-Kortum, R., Sangi-Haghpeykar, H., & Gandhi, M. (2017). Diagnosing postpartum hemorrhage: A new way to assess blood loss in a low-resource setting. Maternal and Child Health Journal, 21, 516-523.