ABSTRACT
New therapies developed for the treatment of postpartum hemorrhage hold considerable promise in expanding the arsenal of the physician in conservatively treating cases refractory to standard therapy. The differential diagnosis of postpartum hemorrhage includes retained placental tissue, uterine atony, lacerations, uterine inversion, and defects in maternal coagulation. Women are at an increased risk of hemorrhage due to uterine atony if they have multiple gestation or polyhydramnios or have recently been administered any medications to reduce frequency of uterine contractions, such as terbutaline. Changes in vital signs can provide some information regarding the degree of hemorrhage, but as the majority of obstetric patients are young and healthy, there can be a considerable amount of blood loss with compensation that can occur prior to a significant change in vital signs. A thorough inspection of all vaginal, cervical, and perineal tissues should be performed as quickly as possible.
