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Postpartum haemorrhage

Haemorrhagia postpartum · Poporodní krvácení

female only

What it is

Heavy bleeding after birth, mostly from a womb that fails to contract; the leading cause of maternal death worldwide.

Symptoms & signs

  • Blood loss over 500 ml after birth
  • soft, boggy womb
  • dizziness, fainting, fast pulse
  • pale, clammy skin
  • bleeding that goes on for days (retained placenta)

🚩 Get help if…

  • call 112 / 911 now Soaking a pad an hour or passing clots bigger than a plum after birth
  • call 112 / 911 now Dizziness, fainting, racing heart or cold, clammy skin after birth
  • see a doctor soon Bleeding that gets heavier or smells bad in the weeks after birth
  • see a doctor soon Fever or tummy pain with bleeding after birth

Where it strikes

Medical treatment

  • Oxytocin at birth to prevent it
  • uterine massage and bimanual compression
  • tranexamic acid within 3 hours
  • misoprostol, ergometrine, carboprost
  • removal of retained placenta, repair of tears
  • balloon tamponade, uterine artery embolisation, compression sutures or hysterectomy
  • recombinant factor VIIa for severe bleeding when uterotonics fail — EU-approved 2022

Natural & lifestyle

  • Treat anaemia in pregnancy
  • skin-to-skin contact and early breastfeeding (release oxytocin)
  • give birth where help is at hand

Emerging & experimental

  • Heat-stable carbetocin for hot countries
  • E-MOTIVE bundle with calibrated drapes

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Nipple stimulation and immediate breastfeeding — releases oxytocin; small studies, not a substitute early / small studies
  • Herbal styptics (shepherd's purse, cinnamon) — traditional; untested anecdotal / traditional
  • Eating the placenta (encapsulated) — claimed to restore iron and mood; trials found no benefit not confirmed in trials

ICD codes