Can a Mother’s Obstetric Hemorrhage Result in Injury to the Baby?

pregnant womanAn obstetric hemorrhage is a rare, but very serious medical complication that can arise during pregnancy or delivery. Such a hemorrhage is heavy bleeding during pregnancy, labor, or following delivery. The definition of an obstetric hemorrhage depends on the nature of a delivery. For a vaginal delivery, a hemorrhage involves more the 500 mL of blood loss, while a C-section involves 1000 mL of blood loss.

Bleeding of an obstetric hemorrhage is usually vaginal but can also go into the abdominal canal. No matter its nature, it can present a serious threat to the health of the baby.

Types of Hemorrhages

Two main types of obstetric hemorrhages exist:

  • An antepartum hemorrhage occurs throughout the course of a pregnancy. It may occur any time during gestation, but most commonly involves the rupture of the placenta or the uterus. This presents a life-threatening emergency to the baby. A rupture of the placenta means that the baby will not receive adequate nutrients or oxygen. A uterine rupture can lead to the suffocation of the fetus without immediate intervention such as delivery.
  • A postpartum hemorrhage occurs following the delivery of the baby. Since the baby is already born, a postpartum hemorrhage does not pose any risk of immediate physical harm to the child. However, it poses life-threatening risks to the mother that may interfere with bonding time. If a mother requires treatment such as surgery or a transfusion following a postpartum hemorrhage, the baby may miss important opportunities such as skin to skin time, which helps facilitate breastfeeding and may even produce immune system-boosting benefits.

Either type of hemorrhage can pose some risk of harm to an infant, whether those consequences are immediate or indirect. Even postpartum hemorrhages can affect the infant regarding his or her relationship with his or her mother. Timely intervention is necessary to help save the life of the baby should one occur. In late pregnancy, an immediate delivery may be necessary.

What are the Risk Factors for a Hemorrhage?

Knowing the risk factors for an obstetric hemorrhage can help both patients and providers take preventive actions that help improve health outcomes for both mother and baby:

  • Placental abruption
  • Placenta previa
  • Prolonged labor
  • Use of assistive tools during deliver
  • Previous surgeries to the uterus
  • Anatomical abnormalities of reproductive organs
  • Use of labor induction medications
  • Obesity
  • Gestational diabetes
  • Excess amniotic fluid
  • A large for gestational age baby
  • Previous obstetric hemorrhage

Health care providers can identify risk factors for hemorrhage during routine obstetric care. Once they identify the possibility for hemorrhage, they must monitor patients closely to help improve outcomes.

How Can Physicians Reduce the Risk of Harm to a Baby?

Unfortunately, preventing an antepartum hemorrhage itself is rarely possible. However, knowing a mother’s risk of having a hemorrhage can help physicians provide patient counseling that can protect the baby. For example, a provider might advise a mother with placenta previa to engage in pelvic rest to protect the placenta and reduce the risk of abruption. It’s essential for providers to proactively manage conditions that could lead to fetal injury.

Poor management of medical conditions throughout pregnancy can lead to serious harm to the infant. Examples of potential harm include:

  • Premature delivery of the fetus
  • Stillbirth
  • Oxygen deprivation
  • Neurological damage
  • Cerebral palsy

Mothers with risk factors for obstetric hemorrhage require careful monitoring throughout pregnancy. Appropriate counseling, patient education, and prenatal testing can help improve the outcomes for both the mother and the baby. A mother’s obstetrical hemorrhage can affect the health of a developing child, but with appropriate obstetric care, a provider may be able to address the issues that could lead to such a circumstance from occurring.

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