Post-partum hemorrhage

If a woman bleeds more than 500 cc of blood after delivery, she is considered to have post-partum hemorrhage (PPH). In order to resolve this, the cause of the bleeding should be identified. The differential for PPH is described by the “4 Ts”

T = Decreased uterine Tone (the most common cause of PPH)
T = Trauma (e.g. cervical/vaginal laceration, uterine inversion, uterine rupture)
T = Tissue (e.g. placenta accreta, retained placenta)
T = Thrombin (i.e. coagulopathy)



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