Sylvia W., 21

Sylvia Wasike is a respectful, hardworking 21-year-old who runs a small business to improve her family’s living conditions. Despite her efforts, her modest earnings are insufficient to consistently cover basic needs and medical expenses. Following a home delivery, Sylvia was brought to Kory Family Hospital’s Casualty Department with persistent heavy vaginal bleeding and blood clots. She also experienced weakness, dizziness and lower abdominal discomfort. Assessment identified postpartum haemorrhage, suspected to have been caused by placental tissue remaining in the womb after childbirth. Sylvia received prompt care to stabilise her condition, control the bleeding and address the suspected retained tissue. She was closely monitored for continued blood loss, changes in blood pressure and circulation, and signs of infection. Her family’s limited income makes the cost of this essential care difficult to meet.

The clinical picture is consistent with secondary postpartum haemorrhage associated with retained products of conception following a home delivery. The retained placental or membrane tissue prevented effective uterine contraction and resulted in continued vaginal bleeding. The condition is potentially serious because significant blood loss can lead to acute anaemia and hypovolaemic shock. Prompt assessment, stabilization, uterine management and removal of the retained products are therefore indicated, with monitoring for infection and further blood loss. The prognosis is generally good with timely and appropriate treatment.