Emergency childbirth rupture. Bleeding after delivery (postpartum hemorrhage) After delivery of the baby, a uterus that is not contracting (atonic uterus), ruptured uterus, remaining parts of placenta or baby or infected remaining parts of placenta or baby can cause severe bleeding. Postpartum bleeding is usually managed preventatively by massaging the lower abdomen (fundal massage), which increases contraction of the uterus and stops bleeding. Additionally, steady traction is applied to the cord to prevent trauma, cord avulsion (tearing of the umbilical cord), uterine inversion, and retained placental products, all of which can increase blood loss and/or the risk of infection. Postpartum hemorrhage is
Nuchal cord an improvement in outcomes where cord entanglement was prenatally identified in these cases. Ultrasound measurement of the velocity of flow in the cord may be useful in the management of twins and chronically growth-retarded fetuses. Of course this depends on the training of the sonographer. To date there are no ultrasound courses which teach the identification of nuchal cord to physicians or technicians. A recent review by Wilson of the American Academy of Ultrasonography Technicians recommends the documentation of umbilical cord issues. Management of a presenting nuchal cord should be tailored to prevent umbilical cord compression whenever possible. Techniques to