After the baby is delivered, the placenta is expelled by the contractions of the uterus. These contractions also help control bleeding from blood vessels that get separated from the placenta. Postpartum haemorrhage is the excessive loss of blood postpartum i.e. after delivery, caused by uterine atony, a condition in which the uterus does not contract sufficiently to control bleeding. Other causes for a postpartum haemorrhage include placenta accrete (abnormal attachment of the placenta to the uterus), cervical or vaginal tear, and blood clotting disorders.
Along with excessive bleeding, postpartum haemorrhage may be associated with decreased blood pressure and red blood cell count, increased heart rate, swelling and pain in vaginal and perineal tissues. Postpartum haemorrhage is diagnosed by measuring blood pressure, pulse rate, red blood cell count, blood clotting factors, and by measuring the amount of blood loss.
Postpartum haemorrhage can lead to shock and even death, so quick diagnosis of the cause of bleeding and immediate treatment is important. Treatment involves medication and massage of the uterus to stimulate contractions, removal of placental remains from the uterus, tying off of bleeding blood vessels, compression of bleeding in the uterus and hysterectomy (removal of the uterus).