How can I reduce the risk of delivery hemorrhage?

How can I reduce the risk of delivery hemorrhage?

What is delivery haemorrhage?

Delivery is the third phase of childbirth: the expulsion of the placenta, amniotic membranes and umbilical cord. If you'd like to know more about this subject, we've discussed the symptoms and causes in this article: Delivery hemorrhage, what is it? 

How can delivery hemorrhage be prevented?

To avoid a delivery hemorrhage, a number of preventive measures are sometimes taken. In fact, the Collègue National des Gynécologues et Obstétriciens Français (CNGOF) points out that in the majority of cases of post-partum hemorrhage, no risk factors have been identified beforehand. For this reason, measures to prevent this hemorrhage sare aimed at all women. This begins with an anaesthesia consultation, the aim of which is to establish the minimum measures necessary in the event of haemorrhage.

Nevertheless, women "at risk", as we lhave already seen, are particularly closely monitored. In the third trimester, women who have already suffered a delivery hemorrhage will receive an iron supplement to reduce the risk ofanemia.

In addition, as we explained earlier, after delivery, the woman is monitored for 2 hours in the delivery room to check, among other things, that the uterus is retracting properly. During this period, her heart rate, blood pressure and uterine tone are checked to ensure that she is not hemorrhaging. If anything abnormal is found during this period, a blood sample is taken from the patient's finger to instantly check her hemoglobin level. If bleeding is detected, the nursing team investigates the cause. A multidisciplinary team is then deployed. 

In addition, a number of techniques are now available, notably in the UK, to improve management of severe hemorrhage. These include s'an intra-uterine balloon for in-house haemostasis. This would make it possible to avoid certain transfers to qualified maternity hospitals. Over the next few years, it is possible to envisage widespread use in France.  

Treatment after a delivery hemorrhage?

First of all, if there is the slightest doubt about a possible post-delivery hemorrhage, the nursing team will, with the patient's consent, perform a uterine revision, also known as artificial delivery. This procedure verifies that the placenta has been expelled and that nothing remains in the uterine cavity. It consists in manually moving the uterus, under epidural or general anaesthetic, to extract any remnants of the placenta.

If, on the other hand, the cause is uterine atony, i.e., as we saw above, the uterus is not recontracting or is not recontracting sufficiently, a massage will be performed to stimulate it, as it is essential to have contractions again to stop the bleeding. If this is the case, you can use an organic cotton period pants to absorb the bleeding. It may also be possible to deliver oxytocin by vein to help the uterus contract back to more or less its original size. For most delivery hemorrhages, treatment stops here. If this is still not enough, prostaglandin, a stronger drug, can be administered to increase contractions. 

However, if it's not the uterus that's bleeding (or not just the uterus), but the vagina or cervix, a check will be made using valves to see inside the vagina. If a tear is found, stitches will be needed to stop the bleeding. 

If the woman has bled a lot and for a long time, does not have enough platelets or has poor coagulation factors, a coagulation test will be carried out to check coagulation status and iron levels.

Moreover, if the mother is below a critical threshold, she will be placed in intensive care and, in very rare cases, a blood transfusion will be considered.

Finally, if nothing has worked and the bleeding is still present, the woman will undergo surgery to stop the bleeding, consisting of embolization of the uterine arteries or artery ligation. Padding may also be considered, which consists of sewing the uterus back onto itself to compact it and prevent bleeding. As a last resort, a hysterectomy is performed, i.e. removal of the uterus.

However, just because you had a delivery hemorrhage in a previous pregnancy doesn't mean you'll have to have another one in your next pregnancy - it all depends on the reasons for the hemorrhage. Nevertheless, the patient will be advised to give birth in a level II maternity hospital, and also to take an iron supplement during the third trimester of pregnancy.

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The information contained in the articles on is general information only. Although reviewed by health professionals, this information is not error-free, does not constitute health advice or consultation, and is not intended to provide a diagnosis or suggest a course of treatment. Under no circumstances may this information be used as a substitute for medical advice or consultation with a healthcare professional. If you have any questions, please consult your doctor.