Post-Partum Haemorrhage
If a post-partum haemorrhage is not quickly identified and effectively treated the outcome can be devastating, resulting in a hysterectomy or even death.
If you or your loved one has been the victim of obstetric negligence, please get in touch with us at Glynns Solicitors. There could be grounds for a medical negligence claim.
What is a post-partum haemorrhage?
A post-partum haemorrhage (PPH) is when a woman loses a lot of blood after giving birth due to a damaged blood vessel.
The precise definition of primary post-partum haemorrhage is when a woman loses 500ml of blood or more within 24 hours of giving birth. A PPH is considered to be major if the blood loss is 1000ml to 2000ml, and severe if the blood loss is more than 2000ml.
If excessive blood loss occurs after 24 hours of the birth (and up to 12 weeks postnatally), it is known as a secondary post-partum haemorrhage.
What causes a post-partum haemorrhage?
A PPH happens because the blood vessels have become damaged and are bleeding.
Often this occurs after the placenta has been delivered, because it comes away from the uterus wall, tearing the blood vessels. Normally the uterus will continue to contract, which puts pressure on the bleeding vessels, stemming the blood loss. But if these contractions are not strong enough, the vessels will continue to bleed.
A PPH can also happen because of tears in the vagina, cervix or uterus, retained placental products, and a collection of blood (haematoma) inside the vulva or vagina.
Who is at risk of a post-partum haemorrhage?
There are certain factors that increase the risk of a post-partum haemorrhage. These include:
- Placental abruption
- Placental praevia
- Multiple pregnancy
- Pre-eclampsia
- Previous PPH
- Asian ethnicity
- Obesity
- Anaemia
- Delivery by caesarean section (elective and emergency)
- Induction of labour
- Retained placenta
- Assisted vaginal delivery
- Prolonged labour
- Larger than average baby
- Fever in labour
- Being over 40 years old
How is a post-partum haemorrhage diagnosed?
If there is a PPH, the patient will experience uncontrolled bleeding from the genital tract. The blood pressure will drop and the heart rate will increase.
When these issues arise after a birth, the obstetric team should quickly recognise a possible haemorrhage. Urgent action should then be taken to stop the bleeding.
How is a post-partum haemorrhage treated?
The treatment for a PPH depends upon the underlying cause, and the extent of blood loss.
If the haemorrhage is minor and is being caused by retained bits of placenta, it may be sufficient to administer medicine to stimulate contractions and insert a vaginal pack. But if the haemorrhage is more severe, a Bakri balloon or Foley catheter may be inserted into the uterus to place pressure on the bleeding vessels. The patient will also need an intravenous blood transfusion and fluids to replace those that have been lost.
If the source of the bleed cannot be identified, a patient will need surgery during which the injured blood vessels must be located and sealed.
If these measures are unsuccessful, a hysterectomy will be required or the patient is at risk of suffering fatal blood loss.
Post-partum haemorrhage deaths
Post-partum haemorrhage is a leading cause maternal death, both in the UK and the rest of the world. A 2003-2005 report found it to be a third highest cause of maternal death in the UK, resulting in 6.6 deaths for every million births.
However, the Royal College of Obstetricians and Gynaecologists (RCOG) states that the majority of post-partum haemorrhage deaths are preventable. In the 2003-2005 report, 10 out of the 17 PPH patients were found to have received 'major substandard care'.
The level of care will be considered substandard if medical practitioners fail to notice the bleed, fail act with the necessary urgency, and fail to carry out effective treatment. It may also be considered negligent if the birth was poorly managed, directly contributing towards the haemorrhage occurring. Examples of this include allowing the second stage of labour to continue for too long, and applying forceps incorrectly.
If such failings result in the patient's death, there will be a case of medical negligence. This will give the patient's family the opportunity to sue those responsible, if they wish to do so. This can help grieving relatives obtain a sense of justice, and can also help prevent the same mistakes being made in the future.
Post-partum haemorrhage hysterectomy
Medical negligence claims also arise when medical failings cause the patient to suffer life-changing injuries such as a hysterectomy. If the haemorrhage is not diagnosed or stopped quickly enough, the patient may need a hysterectomy to prevent further blood loss. This will make the patient infertile and will bring about the early onset of the menopause. This can be very difficult to deal with, particularly if the patient was hoping to have more children.
There can also be a long recovery process after a haemorrhage leading to a hysterectomy, and often the psychological injuries last must longer than the physical damage.
If medical practitioners failed to manage the labour adequately resulting in a haemorrhage and hysterectomy, there could be a case of medical negligence. The same is true if medical practitioners failed to detect the bleed quickly and/or failed to provide effective treatment.
Post-partum haemorrhage claims
If you would like to know more about suing a hospital for a post-partum haemorrhage, please get in touch with us at Glynns Solicitors. We specialise in medical negligence claims and will be able to advise you upon your legal position.
Whether the potential claim relates to you or your loved one, we will ask you to describe your experience and the injuries that have resulted. We will do this during a free initial enquiry which is completely free of charge and obligation. After considering your case, we will say whether or not you are able to pursue a medical negligence claim.
If you are entitled to pursue legal action and you would like to proceed, we will handle the claim on your behalf. Contact us today to speak to a medical negligence solicitor.
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