A normal delivery must occur spontaneously within the 30 minutes after birth The delivery or expulsion of the placenta and its membranes, will allow the uterus to retract, resulting in a physiological way which is called "globe uterine safety.This retraction associated with the myometrial contraction compresses the uterine vessels remained gaping at the placental insertion zone. This is the process of local physiological hemostasis. The delivery brings together four physiological conditions: -Correct uterine retraction -Complete uterine emptiness (uterine retraction required for proper hemostasis is possible only if the uterus is completely empty)-Normal blood clottingAn anomaly of one or more of these four conditions can lead to postpartum hemorrhage.
Postpartum hemorrhage ( PPH:)
It is uterine bleeding that occurs within 24 hours after birth and whose volume exceeds 500 ml blood lost.The main causes of postpartum hemorrhage are: -uterine atony (failure of uterine contraction)-retained placenta (incomplete delivery)-bleeding disordersPreventive actions:Examination of Uterus: It is routine in cases of doubt on the integrity of the placenta and / or membranes during the examination of the latter.Directed delivery: Injection of product tonic-utero at the time of birth, thus allowing for increased uterine contractions and to help the delivery
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Victor Hugo