DRG Category: 765
Mean LOS: 5.2 days
Description SURGICAL: Cesarean Section with CC or Major CC
DRG Category: 774
Mean LOS: 3.3 days
Description MEDICAL: Vaginal Delivery with Complicating Diagnoses
A postpartum hemorrhage (PPH) is frequently defined as a blood loss of greater than 500 mL after giving birth vaginally or a blood loss of greater than 1,000 mL after a cesarean section. Because many women lose at least 500 mL of blood during childbirth and do not experience any symptoms, a more accurate way to define PPH is losing 1% or more of the body weight after delivering a baby (1 mL of blood weighs 1 g). For example, a patient weighing 175 lb (80 kg) would need to lose 800 mL of blood to be classified as having a PPH. Greater than a 10% decrease in the prenatal hematocrit is another means used to suggest that PPH has occurred; this value needs to be used cautiously because hematocrit is affected by factors other than blood loss, such as dehydration. It is estimated that 2% to 4% of all deliveries end in PPH, and it is a major contributor to maternal morbidity and mortality.
PPH is classified as either an early hemorrhage (occurring during the first 24 hours after delivery) or a late hemorrhage (occurring more than 24 hours after delivery). With the current trend in obstetric practice of sending postpartum patients home in 48 hours or less after delivery, the significance of PPH, particularly late hemorrhage, is profound. Often, the severity of the hemorrhage depends on the expediency with which it is diagnosed and treated; if the patient hemorrhages at home, her risk increases significantly.
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