Postpartum hemorrhage (PPH) is the leading cause of maternal morbidity in the US and the globe. When unrecognized by providers, PPH can quickly cause disability or death.
Approximately 100,000, or three percent, of new mothers experience PPH in the US each year. Recent research suggests the incidence of PPH is rising.
During labor and delivery, focus in the delivery suite is on a healthy baby. Following birth, the uterus naturally contracts to deliver the placenta. Contractions that help push out the placenta also place pressure on the blood vessels where the placenta was attached to the uterus. This naturally slows post-delivery bleeding. For a number of reasons, for some women, the bleeding does not stop. PPH can be caused by several factors following a vaginal or cesarean birth, including:
- An abrupted placenta, placenta previa, or retained placental pieces
- Vascular damage in the uterus, cervix, or vagina
- A hematoma, or hidden bleeding in the pelvis
- Issues with blood clotting, or high blood pressure
- Prolonged birth or large babies
When bleeding is not addressed or noticed immediately after delivery, the delay in treatment has a big impact. If there are gaps in medical charting during delivery, the lack of documentation can also cause nursing staff to minimize the symptoms displayed by new moms, such as rapid heartbeat and dropping blood pressure. PPH affects the liver, heart, and kidneys. Transfused blood products carry their own risks, including lung injury, reaction to the product, risks of infection, and formation of antibodies that could impact another pregnancy.
If the amount of blood lost during delivery is not charted, women who experience a drop in blood pressure after delivery may not be identified as having PPH until they are returned to the OR. Notes Dr. Peter Cherouny with the New York State Obstetric Hemorrhage Project, “If we don’t know how much blood a mother loses, it’s hard to know if she is in danger. And right now, most hospitals use poorly effective means to gauge blood loss. Care teams can look and guess based on what they see, but their guesses are rarely accurate.”
Dr. Cherouny recommends set-up, simulation, and practice using a standard postpartum hemorrhage cart. Because women suffering severe PPH can bleed out in six to ten minutes, fast access and skilled treatment is critical. The Joint Commission recently detailed a simulation using a cart and kit to speed treatment of PPH. The tools increase the speed by which women are treated by reducing the time spent gathering treatment tools and medications.
With PPH, the health and wellbeing of a new mother depends on fast recognition and treatment of the condition. If you believe you were injured due to negligence in the birthing suite, speak with an attorney with our legal team.
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Schochor and Staton, P.A. is an award-winning law firm representing patients injured through medical error. If you suffer serious medical harm, we can help. Contact us or call 410-234-1000 to schedule a free consultation. We have offices in Washington, DC and Baltimore, Maryland.