Postpartum haemorrhage in questions

Postpartum haemorrhage in questions

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Thanks to medical progress and obstetric surveillance, maternal death has become a rare event, but has not disappeared. The lights of Professor Gérard Lévy, obstetrician-gynecologist and chairman of the National Expert Committee on Maternal Mortality.

Postpartum haemorrhage, what is it?

  • Also called haemorrhage of the delivery, this haemorrhage of uterine origin is responsible for a big blood loss of at least 500 ml.
  • Complication feared, it occurs within 24 hours after delivery.
  • She is diagnosed most often within two hours of delivery, during which time the young mother remains under the supervision of the medical team, in the birth room.
  • It is the leading cause of maternal mortality in France.

Maternal mortality, what is it?

  • Maternal death is defined as any death occurring during pregnancy or within 1 year after birth, where the pregnancy is considered to have contributed to the aggravation of the woman's state of health and resulted in her death. .

What are the different causes of maternal mortality?

  • Indirect causes: when pregnancy is the aggravating factor of an existing pathology, such as certain chronic heart diseases or diabetes.
  • Direct causes: when pregnancy alone is responsible for the death. As is the case for eclampsia, pulmonary embolism, amniotic embolism, and postpartum haemorrhage.

Improving results, but what progress still needs to be made?

  • Thanks to medical progress and obstetric surveillance, maternal death has become a rare event, but has not disappeared.
  • The reduction of maternal mortality by postpartum haemorrhage is to be related to the important mobilization of professionals for years. However, while the quality of obstetric care is steadily improving, new risk factors have emerged: the increasingly advanced age of mothers (risk multiplied by 5), obesity (risk multiplied by 3) and insecurity.
  • In order to reduce the maternal mortality rate, the National Expert Committee on Maternal Mortality made recommendations, which include: pre-conception risk assessment of a pregnancy when a condition is pre-existing; medical examination of the pregnant woman outside the obstetric sphere (cardiac examination), the maintenance of vigilance after delivery when the mother returns to her home ...
  • Recommendations that are disseminated to midwives, gynecologists-obstetricians, anesthetists and other birth professionals.

Frédérique Odasso