pathophysiology postpartum hemorrhage

[Lanesmama]

Hi all,

I am in a group project for postpartum hemorrhage. We have been asked to define the health problem, provide pathophysiology, etc.

I am a bit confused because pathophysiology is disease process but PPH isn't a disease but rather a negative side effect of pregnancy/delivery.

One of my group members is insisting that the following is the pathophysiology. I believe that is defining the health problem: "PPH, according to Perry, Hockenberry, Lowdermilk, and Wilson (2010), "has been defined as the loss of 500 ml or more of blood after lady partsl birth and 1000 ml or more after cesarean birth." It may also be defined as a 10% change in hematocrit (Perry et al., 2010). However, McLintock and James (2011) mention that hemorrhage must be measured by not only blood loss measurement but also the physiological state of the woman, comorbidities, and time frame of blood loss (McLintock and James, 2011)."

I would think that since we are required to write a pathophysiology that we should write something about it not having a specific pathophysiology because it isn't a disease process.. and talking about PPH being a side effect and that being pregnant, really, is the pathophysiology of it. Also that it is the failure to attain hemostasis following delivery. What do you all think? Any help would be awesome! :)

[nurseprnRN, BSN, RN]

I like how you're thinking. It's not a side effect of delivery/section, though, thank goodness :), it's a complication.

You might want to look at the pathophys of hemorrhage in general, and what happens when it occurs (the systemic effects, not "duh, there's blood loss" :) ) and how it's managed, and how and why the management interventions work, and how they are monitored.

So...

What happens when there's a significant blood loss? How do you know? How is this usually discovered (if bleeding isn't immediately visible and, by contrast, in postpartum hemorrhage)? Then what happens?