Labour and Delivery

Table IV

Causes of excessive bleeding after delivery

A. Uterine causes 1. Lax or "atonic uterus" 2. Low lying insertion of placenta (bleeding harder to spot) 3. Uterine tumours e.g. fibroids 4. Uterine rupture 5. Cervical tear

B. Other causes 1. Vaginal / perineal tear 2. Weak blood clotting e.g. D.I.C. (disseminated intravascular coagulation)

Management decisions in Labour
When assessing the progress of the labour, all the factors in table I should be taken into account. There are three choices for the doctor / midwife and patient to discuss at any given situation.

1. Do nothing and allow the labour to progress naturally. (Appropriate if progress is satisfactory with no sign of problems)

2. Encourage the labour the through intervention, mobilise, good analgesia, Syntocinon infusion. (cont. next page)