11.3 Traumatic postpartum haemorrhage
In traumatic postpartum haemorrhage, excessive bleeding occurs as a result of trauma (injury) to the reproductive tract following delivery of the baby. Trauma can occur to the cervix, vagina, perineum or anus. It could also be from a ruptured uterus (see Study Session 10). Signs of traumatic postpartum haemorrhage are when there is bleeding from the vagina but the uterus is well contracted (hard).
Trauma to the reproductive tract is preventable through skilled and gentle management during delivery, and referring the mother in good time if the labour is prolonged, or if the fetus is in an abnormal presentation or malposition (Study Session 8).
11.2.1 Causes of atonic PPH