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A Bakri balloon is a balloon tamponade specifically constructed for uterine postpartum hemorrhage. [45] While effective, commercially available devices may be expensive for settings in which postpartum hemorrhage is most common. Low-cost devices, such as the ESM-UBT, have been shown to be effective without the need for operative intervention.
The highest rate of uterine perforation appears to be in the setting of postpartum hemorrhage (5.1%) compared with a lower rate in diagnostic curettage in non-pregnant patients (0.3% in the premenopausal patient and 2.6% in the postmenopausal patient). [17] Perforation may cause excessive bleeding or damage to organs outside the uterus.
Other definitions of excessive postpartum bleeding are hemodynamic instability, drop of hemoglobin of more than 10%, [12] or requiring blood transfusion. In the literature, primary postpartum hemorrhage is defined as uncontrolled bleeding that occurs in the first 24 hours after delivery while secondary hemorrhage occurs between 24 hours and six ...
A common practice is to offer a transfusion to symptomatic women with a hemoglobin value less than 7 g/dL. In most cases of uterine atony-related postpartum hemorrhage, the amount of iron lost is not fully replaced by the transfused blood. Oral iron should thus be also considered. Parenteral iron therapy is an option as it accelerated recovery.
An increase in lochia between 7–14 days postpartum may indicate delayed postpartum hemorrhage. [23] Hemorrhoids and constipation in this period are common, and stool softeners are routinely given. [24] If an episiotomy or perineal tear had to be sutured, the use of a donut pillow allows the woman to sit pain-free or at least with reduced pain.
Bleeding in excess of this norm in a nonpregnant woman constitutes gynecologic hemorrhage. In addition, early pregnancy bleeding has sometimes been included as gynecologic hemorrhage, namely bleeding from a miscarriage or an ectopic pregnancy, while it actually represents obstetrical bleeding. However, from a practical view, early pregnancy ...
[1] [2] For low resource countries, the combination of poor nutrition, lack of access to simple therapy with iron replacement, and the symptom of heavy menstrual bleeding (HMB) are collectively responsible for the global epidemic of iron deficiency anemia, a circumstance that sets up a pregnant population vulnerable to peripartum hemorrhage and ...
Uterine artery embolization can also be used to control heavy uterine bleeding for reasons other than fibroids, such as postpartum obstetrical hemorrhage. [12] Many women who experience postpartum hemorrhage may be successfully treated with medication or uterine balloon tamponade . [ 13 ]