Postpartum hemorrhage

This chapter focuses on the obstetrical patient experiencing a postpartum hemorrhage (PPH). The goal is to identify the emergency, explain the etiology, and understand general management tools to assist in decision‐making during such emergencies. The chapter introduces two clinical scenarios and lead you through management decisions for the event based on best available evidence. It explores the effective medical interventions that can be used to decrease further bleeding in pregnant patients experiencing acute postpartum hemorrhage. The chapter examines whether invasive procedures prevent further hemorrhage and decrease the need for hysterectomy. The patient with an acute PPH from uterine atony can be managed medically with oxytocin IV as well as administration of uterotonics. It provides information on maternal comorbidities, and controlling/preventing hemorrhage. The complications associated with conservative management must be anticipated, and the patient adequately counseled prior to attempting such therapy. Such complications include delayed hemorrhage, disseminated intravascular coagulation, endomyometritis, and sepsis.