Risk+Factors

=Risk factors for Postpartum Hemmorhage (PPH) =

__Early, acute or primary PPH occurs within 24 hours of birth__
**Usual Causes:** Uterine atony (loss of uterine muscle tone)-can be caused by multiple births/large fetus/fetuses, prolonged labor, oxytocin induced labor, excess amniotic fluid, trauma during labor and birth-forcept-assisted birth, vaccum-assisted birth, cesarean birth, hypertensive disorders leading to preeclampsia, cervical incompetence, and recurrent abortions.

__Late or secondary PPH occurs more than 24 hours but less than 6 weeks after birth__
**Usual Causes:** Infection, lacerations of the birth canal, retained placental fragments, ruptured uterus, inversion of the uterus, coagulation disorders, placental abruption, placenta previa, manual removal of a retained placenta, magnesium sulfate administration during labor or postpartum period.

References Perry, S., Hockenberry, M., Lowdermilk, D., & Wilson, D. (2010). //Maternal child nursing care//. (4 ed., pp. 576-579). Maryland Heights, MO: Mosby Elsevier.

Sheiner, E., Sarid, L., Levy, A., Seidman, D.S., & Hallak, M. (2005). Obstetric risk factors and outcome of pregnancies complicated with early postpartum  hemorrhage: A population-based study. //Journal of Maternal-Fetal & Neonatal Medicine, 18//(3), 149-154.