Postpartum Hemorrhage
Medically reviewed by Drugs.com. Last updated on Apr 6, 2025.
What is postpartum hemorrhage (PPH)?
PPH is the loss of large amounts of blood after delivery. Primary PPH happens within 24 hours of delivery. Secondary PPH happens 25 hours to 6 weeks after delivery. PPH is life-threatening no matter when it happens.
What increases my risk for PPH?
- Uterus is stretched too much, or more than 4 vaginal deliveries
- Long labor, certain medicines, or fibroids
- Delivering a large baby
- A blood clotting disorder, such as idiopathic thrombocytopenic purpura (ITP), or von Willebrand disease
- An episiotomy (cutting of the perineum to prevent more severe tearing during delivery)
- Use of instruments such as forceps to help deliver the baby
What may cause PPH?
- Uterus stays soft and lacks tone (called atony) instead of contracting to close blood vessels
- Trauma such as a cut or tear to your vagina, uterus, or perineum
- Placenta tissue that stayed attached to the uterus, preventing blood vessels from closing properly
- Blood clotting disorders that make it difficult for your body to stop heavy bleeding
What are the signs and symptoms of PPH?
- Heavy bleeding (using more than 1 pad in 1 hour)
- Fast breathing, a fast heartbeat, or blurred vision
- Cool, clammy, or pale skin
- Pain or swelling in your vaginal area
- Being lightheaded, faint, or dizzy
- Fever
How is PPH diagnosed and treated?
Your healthcare provider will diagnose PPH by your symptoms. Your provider will also do a pelvic exam. You may also need to have an ultrasound to check your uterus. Treatment may include any of the following:
- Medicines to help your uterus contract and help control bleeding
- IV fluids and blood transfusions
- A balloon inserted into your uterus, filled with saline to put pressure on uterine walls to control bleeding
- Surgery to stop bleeding or remove placenta left in your uterus
- Uterine artery embolization to block major blood flow to your uterus
- Removal of your uterus (hysterectomy)
Call your local emergency number (911 in the US) if:
- You have heavy bleeding (using more than 1 pad in 1 hour).
- You are dizzy or lightheaded.
- You have fast breathing and a fast heartbeat.
- Your skin is cool and clammy.
When should I seek immediate care?
- You urinate little or not at all.
- You have a fever or chills.
When should I call my doctor?
- You have bad smelling vaginal discharge.
- You have questions or concerns about your condition or care.
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