What is PPH? What are the causes dnd types of PPH.

Q.What is PPH? What are the causes dnd types of PPH.

Post partum haemorrhage :- The term denotes excessive hemorrhage form the genital tract at any time after the birth of baby up to the end of puerperium ammounting to a degree affecting the general condition of the patient for statistical purpose hemorrhage of more than 500 ml is defined for post partum hemorrhage.

Types of PPH:
1. Primary PPH - Hemorrhage occurs with in 24 hours following the birth of the baby of delivery.
2. Secondary PPH – Hemorrhage occurs beyond 24 hours and with in puerperium of delivery until 6 weeks

Causes of PPH-
A. causes of primary pph (After 3rd stages within 24 hours)

1> Atonic uterus (80%)
1. Grand multipara.
2. Over distension of the uterus as in multiple pregnancy, hydramnios and large baby.
3. Malnutrition and anaemia.
4. Antepartum haemorrhage.
5. prolonged labour.
6. Anaesthesia.
7. Persistent uterinc distension.
8. Malformation of the uterus.
9. uterine fibroid.
10. Mismanaged third stage of labour.
11. constriction ring.
2> Traumatic (20%)
3> Combination of atonic and traumatic cause.
4> Blood coagulation disorders, acquired of congenital.

B. Causes of secondary pph (usually occurs between 8th-14th day of delivery)
1. Retained bites of membranes.
2. Infection and separation of slough over a deep cervico-vaginal laceration.
3. Endometritis and subinvolution of the placenta site.
4. Secondary haemorrhage from caesarean section.
5. Blood Clots.
6. uterine fibroid.
7. Rare cause
Carcinoma cervix
Placental polyp.