Hello or good evening depending on what time you are going to watch this video. It is always a
pleasure for me to be able to be with you every Monday to give you health advice.
particularly today I am saddened because in less than two weeks I was informed of
2 deaths and it is quite sad. Ladies with a future who have gone to be able to give birth.
we expected the joy of the baby to be able to see the mother again and to be able to rejoice in this new
birth. And we are rather saddened, we are in mourning because we gave life and there is
another life that was reprise. I would like to share my sincere condolences with all
the families who have already had to lose either their wife, their daughter or their sister following
childbirth.As a doctor who would like sensitivity who would like to help and who would like to
see people live a long life and in good health i found it fair to be able to tell you about what
is called postpartum hemorrhage which is one of the most common causes of death
after childbirth and therefore probably these two young ladies suffered from it So
please stay until the end of this video so you can learn more.
It's immediately with Sweetdoctor. Indeed today we are going to talk about a very important subject
which is postpartum hemorrhage, that is to say hemorrhages just after
childbirth. For those who don't know me, I am Dr olivia Tchoupe from the sweetdoctor
page . I post every Monday and am a general practitioner and reside in the United States.
I created this youtube channel to be able to help you learn more about your health because
my motto is prevention is better than cure without further delay we are going to move on to this
day. We are going to talk about Postpartum hemorrhages which have already had killed several women
following childbirth. You should know that we are talking about postpartum hemorrhage when you
have a bleeding that exceeds 500 milliliters of blood after a childbirth it means
that you have a postpartum hemorrhage or when after a cesarean section you have a
Blood loss that exceeds 1000 milliliters is really a matter to be taken seriously
because if you lose your blood then you are bound to go into hypovolemic shock
and the risk of death is high. Now, who are the people who are at risk
of developing this postpartum hemorrhage? when we did studies we
realized that most women who develop postpartum hemorrhages
are women who have placenta previa, that is to say that the placenta is inserted low
at the level of the cervix. the uterus there is also what is called the placenta abruptio which is a
detachment of the placenta from the uterine lining before childbirth. It is when there is
detachment of the placenta. The placenta is no longer well fixed at the level of your uterus then we speak
of placenta abruptio. These women are precisely at risk of bleeding after childbirth. We
also have infections, we have people who are multiparous, that is to say who have already had
several pregnancies because the more you give birth, the stronger your uterus will be. We also have
people who are really overweight while they are pregnant and whose stomachs are
really too distended. These people are at risk of being able to have a
postpartum hemorrhage. As another risk factor that can be cited is arterial hypertension, yes this
famous term that comes up all the time; when you have high blood pressure and also
the mother's age . Pregnancy over 40 years. When you get pregnant after 40 years,
then you have more risk of having postpartum hemorrhage. Here are the
factors so I can cite.We also have women who give birth not forcep, that is to
say that we are obliged to take something like ladles to be able to get the
head of the child out or even women at home. which an episiotomy will be done,
i.e. the medical team is obliged to make an incision in the vagina to widen the
passage of the baby to be able to get the baby out of your vagina so these are some of the people
who are at risks without obviously forgetting people who have twin
pregnancies . These are people who are at risk of being able to develop
postpartum hemorrhage . Now what is the main cause? The main cause is
UTERINE ATONIA, ie the inability of the uterus to be able to contract because
it is the contraction of the uterine muscle that makes it possible to stop the
bleeding. So if the uterus does not contract after giving birth then you are
going to bleed, you will bleed and die. Now what are the signs that
should bring to mind a postpartum hemorrhage? as I said above,
a woman who after a vaginal birth has a blood loss that exceeds 500 milliliters
then we must be able to think of a postpartum hemorrhage, if suddenly the woman begins
to have a tachycardia it is to say that the beat of her heart starts to rise so
she starts having in the 120 heartbeats per minute, then you must think of a
hemorrhage if the respiratory rate is high enough i.e. a respiratory rate between 20 and 24 beats per minute then you must think of a postpartum hemorrhage
if suddenly this person has low blood pressure, we take the blood pressure
we realize that the blood pressure does not drop, you must think of a
postpartum hemorrhage partum, if the patient suddenly begins to sweat and all have
large drops of sweat, you should think about postpartum hemorrhage and when
doing a formula count sore throat and you realize there is anemia, then you must be
thinking about postpartum hemorrhage. This is what I would really like to tell you and attract
your attention . But today, I will insist more on prevention. How to avoid
arriving at this? my dear ladies and dear men, please; It is very important
when you are pregnant to be able to take stock, to be able to go to the hospital for follow-up
because the problem we have in certain countries like where I come from which is Cameroon; is
that most patients play a lot with their life and some will say to themselves that they
have already had several deliveries, so inevitably the other delivery will always be
fine. Many women do not have ANC ( prenatal consultation), they do not even come to the hospital for
follow-up. There are many who do not do ultrasound scans. You should know that
ultrasound is very important. The three ultrasounds that you are asked to do; the
first trimester ultrasound, the second trimester ultrasound, the third
trimester ultrasound because the third trimester ultrasound will allow you to be reassured
that there is no is not a problem like the case with the placenta previa which is the low placenta inserted
at the level of the cervix if it is discovered at the level of the ultrasound of the third trimester, then
your gynecologist will take measures is not it to prevent you that could have
complications if for example we have an abruptio placenta that is to say a detachment of the placenta and
then that would be very important also for the infections which are part of the risk
factors of the people who will have the hemorrhages of the post partum so if you have an infection and
you don't do your workup, how are we going to find out that there is a problem?
how are we going to be able to save your life? by doing an infectious assessment, if you
have an infection, we will treat and then you will be able to give birth without any problem. There
is also the problem so I would really like to draw attention here is to be able to
do the full blood count because if you are already anemic while you
are pregnant then the risks are even higher for you to have a hemorrhage. post partum
to make things more complicated. So it is very important to do
a full blood count that will allow you to see your hemoglobin level we will be
reassured that you have enough iron that you have enough blood before you can before
your delivery so it is as much of an element that must be taken into account. We are
already in the 21st century where medicine has really evolved a lot, before in antiquity,
many women died when they gave birth. Most women still wore the
wedding dress for their funeral after giving birth because we knew that the risk of death was
really very high now with the advancement of technology, with medicine
being quite advanced then. it would be really quite sad to see women who
still die from this postpartum hemorrhage and rest assured when you have already
hit the age of 40 and you get pregnant you really have to be careful and get followed
in a hospital in the place where you can have access to an operating room because
whatever the risk there is, we should be able to quickly bring you to the operating room
to be able to save not only the life of the baby, but that we can also save your life so it is very
important to be able to take this into consideration try to be able to make your visits to be able
to protect yourself and the child you are carrying in your life. between. You have to make an
effort when you are at risk of not being able to give birth in a hospital where there will be a block
that will be available to be able to bring you in case there is a problem. know that medicine is
not something fixed medicine is not something that is optimally adapted
to each person each person is variable, each person to his specificity. The proof
is that people change depending on the circumstances depending on the situation each pregnancy
is not the same, each pregnancy has its history, each pregnancy has its reality. So ladies,
do not say that because you have already given birth of them; three; four times that you are already experts
in childbirth. No pregnancy is the same No pregnancy is the
same so take this seriously because it saddens me in fact
it saddens me to be able to realize that instead of to be able to give life then you have a
death. Try to do whatever is within your level so that things can be okay
. I am not saying that when you have done all this you will not have death, but
you should at least reassure you that you have done everything there is to do.
Please do not make children if you do not have enough resources so if you've ever had to
make kids Take a contraceptive method not to end up with an unwanted
pregnancy and that will put you in trouble comfortable or not you might not be able to do the right
exams. Yes many will often say that it is the good Lord but I assure you the creator
gave intelligence to the men to be able to help you. In everything is not necessarily resolved by
prayer. There are things you need to do to be able to put the
odds on your side so that everything goes really well. So as a conclusion and as a closing word
, I would like to say that postpartum hemorrhages are due precisely to a loss of
blood greater than 500 milliliters for women who give birth not vaguely and greater
than 1000 milliliters for women who give birth by caesarean section and the main cause is what is
called UTERINE ATONIA, that is to say incapacity of your uterus to be able to contract and
the risk factors that can be found in fact are: the placenta previa that
is to say a placenta not inserted that will obstruct the opening of the cervix for stage 3 and 4
Placenta Abruptio which is a premature detachment
of your placenta from your uterus, we have infections; we have arterial hypertension that
is why it is very important when you are hypertensive, to be able to do everything to
manage your arterial hypertension well, the same for people with diabetes
because we would not want for people with diabetes, to have children who are macrosomes, extremely large which will
cause hyper-extension of the uterus Because the larger the fetus, the more the uterus
will be distended and the greater the risks will be of being able to have uterine sluggishness, that is to
say an inability of your uterus to contract well. This is normal because it is a muscle
and the muscle when it is stretched too much it can burst and that creates problems for you.
So this is why it is very important to be careful and it is the same for women who have twin pregnancies because the
twin pregnancy will cause the uterus to stretch making the risk of having a hemorrhage higher.
Hence the recommendation of a fairly close and regular follow-up and you will have to be followed by a specialist
who is gynecologic to be able to have a good care so
prevention is better than cure. When you know you are in this category, then be really
careful, get regular ultrasounds. Ultrasound is
not to enrich the doctor no! ultrasound is to help the doctor
to situate you, to know at what level your pregnancy is, and you even
to be able to manage and know what to do and
choose the right approach to take cope with your childbirth.
Every pregnancy is unique, no pregnancy is the same as every pregnancy in its history
so don't say that you are experts in this but please help us to be able to
do our job well. Help us to be able to reduce the risk of death
from postpartum hemorrhage. I say thank you. If you have questions; leave your reviews
below the video. Ask your questions I will answer. We say see you next week for a new subject.