Postpartum
Hemorrhage

The Devastation of
Maternal Mortality

Facts About Postpartum Hemorrhage

  • It is the leading cause of maternal mortality worldwide

  • It is one of the leading causes of severe maternal morbidity

  • It is unpredictable, 40% of all cases occur in low risk women

  • It is the leading cause of preventable maternal death

  • Delayed diagnosis of postpartum hemorrhage is significantly associated with poor maternal outcomes

ACOG Committee Opinion on Obstetric Hemorrhage

“Analysis of root causes in maternal mortality reviews have consistently found missed or delayed diagnosis and delay in initiating treatment are recurrent problems in care of women with excessive obstetric blood loss. Thus, addressing more accurate and timely diagnosis and treatment of postpartum hemorrhage represents an important quality improvement opportunity for prevention.”

     ACOG Committee Opinion No. 794. See citation below.

Cesarean Sections & Hemorrhage

Baby being born via Caesarean Section coming out.jpg
  • Two potential sources of bleeding - abdominal and vaginal

  • Abdominal access for visual assessment of bleeding is readily available

  • Vaginal access for visual assessment of bleeding is not readily available

  • Currently c-section drapes provide no means to visually assess vaginal bleeding

  • Inability to efficiently assess for vaginal bleeding can lead to delayed diagnosis and treatment resulting in poor maternal outcomes

Current Inefficiencies of

Vaginal Bleeding Assessment
 

  • Nurse required to assess bleeding under the drape

  • Physically challenging

  • Risk of exposure to the patient’s bodily fluids

  • Risk of contaminating the sterile field

  • Prevents nurse from performing other critical duties

  • Limited access, light, and estimation of bleeding

  • Surgeon's critical decision making is limited without visual assessment 

  • Time consuming when every second matters

Doctor demostrating examining the patient using the C-section Drape

References

Quantitative blood loss in obstetric hemorrhage. ACOG Committee Opinion No. 794.    American College of Obstetricians and Gynecologists. Obstet Gynecol 2019; 134:e150-6.​​

Postpartum hemorrhage. Practice Bulletin No. 183. American College of Obstetricians and Gynecologists. Obstet Gynecol 2017; 130:e168-86.