ICD-10 codes
• O44.1 Complete placenta previa with hemorrhage.
• O45.0 Premature separation of placenta with coagulation defect.
• O46.0 Antepartum hemorrhage with coagulation defect.
• O67.0 Intrapartum hemorrhage with coagulation defect.
• O69.4 Labor and delivery complicated by vasa previa.
• O71.0 Rupture of uterus (spontaneous) before onset of labor.
• O71.1 Rupture of uterus during labor.
• O71.2 Postpartum inversion of uterus. O71.3 Obstetric laceration of cervix.
• O71.4 Obstetric high vaginal laceration alone.
• O72.0 Third-stage hemorrhage.
• O72.1 Other immediate postpartum hemorrhage.
• O72.2 Delayed and secondary postpartum hemorrhage.
• O75.1 Shock during or following labor and delivery.
18.1. GENERAL INFORMATION
18.1.1. Epidemiology
Obstetric hemorrhage is a common, dangerous complication of pregnancy and childbirth. Any bleeding from the birth canal during pregnancy, labor or puerperium is regarded as pathological.
Hemorrhage is inside the top five causes of maternal mortality: sepsis, eclampsia, obstructed labor, and unsafe abortion (WHO). Over 50 000 women die of hemorrhage every year. In the Russian Federation, hemorrhage ranks second after extragenital disease in the structure of maternal mortality (according to the Ministry for Health Care of Russian Federation, 2013) and accounts for 20% of deaths.
Although delivery is nowadays managed in hospital settings using up-to-date methods of hemostasis and replacement of the volume of lost blood, hemorrhage remains one of the main causes of maternal mortality in Russia.
This is due to the specific nature of obstetric hemorrhage, its sudden onset and massive flow of blood. Implicitly, obstetric hemorrhage cannot be arrested until magistral blood flow to the uterus is controlled or the uterus is removed as the source of hemorrhage.