Should the uterus be removed due to severe postpartum hemorrhage?

Written by Zhang Lu
Obstetrics
Updated on September 08, 2024
00:00
00:00

Whether postpartum hemorrhage requires hysterectomy primarily depends on the severity of the hemorrhage and the specific causes of the postpartum hemorrhage. First, if the amount of postpartum hemorrhage is very substantial, leading to conditions like DIC in the pregnant woman, and if not removing the uterus may cause ongoing bleeding, it is essential to remove the uterus quickly to reduce vaginal bleeding. Second, if the postpartum hemorrhage is caused by issues like amniotic fluid embolism or poor contraction of the uterus, and conservative treatments are ineffective, it is also necessary to make a prompt decision to remove the uterus.

Other Voices

doctor image
home-news-image
Written by Zhang Lu
Obstetrics
47sec home-news-image

Causes of Late Postpartum Hemorrhage

Late postpartum hemorrhage refers to a significant amount of vaginal bleeding that occurs two to three weeks after a cesarean section or natural childbirth. The causes of late postpartum hemorrhage include the following aspects. First, the presence of residuals in the uterine cavity, such as when the placenta or membranes remain within the uterine cavity after childbirth, can repeatedly stimulate the endometrium causing bleeding. Second, poor healing of the uterine incision during a cesarean section can lead to post-cesarean bleeding, a condition that easily causes late postpartum hemorrhage. Third, poor healing of episiotomy or perineal laceration wounds after natural childbirth can also potentially lead to late postpartum hemorrhage.

doctor image
home-news-image
Written by Yue Hua
Obstetrics and Gynecology
54sec home-news-image

How much bleeding is considered postpartum hemorrhage?

Postpartum hemorrhage refers to a condition where, if the patient has vaginal delivery, the bleeding exceeds 500 milliliters within 24 hours after the fetus is delivered. If the delivery is via cesarean section, the bleeding exceeds 1000 milliliters, which is considered significant postpartum hemorrhage. The primary cause is mostly related to poor uterine contractions. Due to inadequate muscle contractions of the uterus, the blood vessels in the uterine muscle layer remain open, leading to bleeding. Another cause relates to placental factors, such as when the placenta is not entirely expelled, leading to remnants of the placenta and membranes remaining in the uterine cavity, which can also cause postpartum bleeding.

doctor image
home-news-image
Written by Du Rui Xia
Obstetrics
46sec home-news-image

Is it normal to have ovulation bleeding during postpartum breastfeeding?

During the postpartum breastfeeding period, it is normal for mothers to experience bleeding during ovulation. Most women who bleed during ovulation are affected by fluctuations in hormone levels in the body. The bleeding usually occurs midway between two menstrual periods, and the amount of blood is relatively small and light in color. It usually returns to normal within one to two days, so there is no need to worry when ovulation bleeding occurs. It is important to rest, avoid overwork, enhance nutrition, keep warm, and avoid getting cold. During breastfeeding, it is essential to observe the amount of vaginal bleeding. If menstruation resumes, it is crucial to pay attention to contraception.

doctor image
home-news-image
Written by Liu Wei Jie
Obstetrics
51sec home-news-image

What are the warning signs of postpartum hemorrhage?

Postpartum hemorrhage generally does not have warning signs but usually has precipitating factors. These factors include maternal fear, psychological tension, macrosomia or twin pregnancy, as well as conditions like uterine fibroids, placental abruption, or placenta previa. In cases of placenta previa during a cesarean section, there is a high likelihood of severe bleeding. There is only one condition that might signal an impending postpartum hemorrhage, which is placental abruption. If placental abruption occurs, it can cause severe abdominal pain along with issues of hypertension during pregnancy. If a person with pregnancy-induced hypertension experiences severe abdominal pain, this could be a precursor to postpartum hemorrhage.

doctor image
home-news-image
Written by Tang Mei Xiang
Obstetrics and Gynecology
1min 18sec home-news-image

Postpartum hemorrhage causes

Postpartum hemorrhage (PPH) has four primary causes: 1. Lacerations from difficult labor; 2. Placental factors; 3. Uterine atony; 4. Coagulopathy. Immediately after childbirth, if there is bright red bleeding that includes blood clots, this is considered to be caused by soft birth canal lacerations. Approximately 10 to 15 minutes after delivery of the fetus, if significant bleeding occurs, placental factors should be considered. After the placenta is delivered, if the placenta and membranes are found to be intact and there is still vaginal bleeding, or if there is intermittent heavy vaginal bleeding, and the uterus feels soft and poorly defined upon light palpation, uterine atony should be considered as a likely cause of the heavy bleeding. Lastly, coagulopathy, which leads to continuous, dark red bleeding without clots, can also cause severe postpartum hemorrhage.