Sunday Trust - - TAMBARI BEAUTY - Dr. Nathaniel Ade­wole MO­BILE: 0803 8039182 EMAIL: nade­ or tam­bari@dai­

I am thirty five years of age and this is my sev­enth preg­nancy. My worry is that I had se­vere bleed­ing af­ter my two de­liv­er­ies. The last one I was given three unit of blood. Please what do I do to avoid bleed­ing dur­ing this de­liv­ery. Jum­mai, Minna.

Preg­nan­cies af­ter five de­liv­er­ies has a lot of risks and one of com­mon and the feared risk is bleed­ing af­ter de­liv­ery oth­er­wise called post par­tumhaem­or­rhage like you had in your last two de­liv­er­ies.

The first step is for you to reg­is­ter and de­liver in a sec­ondary or ter­tiary health cen­ters prefer­ably un­der an ob­ste­tri­cian. Prior to labour steps would have been taken more im­por­tantly dur­ing de­liv­ery. Po­tent drugs used to en­dure good uter­ine con­trac­tions should be used and af­ter de­liv­ery mon­i­tor­ing closely for the first four hours. Also dur­ing this pe­riod steps would be taken to pre­vent bleed­ing.

One of chal­lenges that lead to bleed­ing af­ter de­liv­ery in our en­vi­ron­ment de­spite the us­age of ap­pro­pri­ate drugs and in­jec­tions is fake or sub­stan­dard in­jec­tions used, we hope NAFDAC will help in com­bat­ting this men­ace. Also a lot of health cen­ters do not have the right en­vi­ron­ment to pre­serve the drugs in or­der to main­tain po­tency. For ex­am­ple one of the com­mon­est in­jec­tions used named oxy­tocin re­quired re­frig­er­a­tors for preser­va­tion of po­tency. And with prob­lem of elec­tric­ity and long stor­age at nor­mal room tem­per­a­ture or even higher tem­per­a­ture (our en­vi­ron­ment ) then po­tency can be re­duced. The health cen­ters should not hes­i­tate to use other forms of utero­tonic that are more heat la­bile.

I will also ad­vise you do fam­ily plan­ning im­me­di­ately af­ter this de­liv­ery. Per­ma­nent form of fam­ily plan­ning like tubal lig­a­tion or any long term fam­ily plan­ning like IUCD will be ad­vis­able.

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