Causes of Late Postpartum Hemorrhage

Written by Yue Hua
Obstetrics and Gynecology
Updated on September 16, 2024
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Late postpartum hemorrhage is most commonly caused by retained placenta and membranes. About ten days after childbirth, the patient may experience significant bleeding due to the degeneration and necrosis of the retained placental and membrane tissues within the uterine cavity. When these necrotic tissues are shed, it can cause the blood vessels to open and lead to bleeding. Additionally, poor healing of the placental site on the uterus can also cause bleeding, as can infections, with endometritis being relatively common. Inflammation can lead to poor healing of the placental attachment site or poor uterine contraction, resulting in significant uterine bleeding.

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Written by Yue Hua
Obstetrics and Gynecology
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What should be done for late postpartum hemorrhage?

If there is a small or moderate amount of vaginal bleeding, high doses of antibiotics should be administered, along with medications to induce uterine contractions. This can reduce the amount of bleeding after the uterus contracts. If there is suspicion of placental remnants or other residues in the uterine cavity, then a dilation and curettage (D&C) surgery may be necessary. Before surgery, it is essential to prepare blood for transfusion in case of excessive bleeding. Additionally, the tissue removed during the procedure needs to be sent for pathological examination. After the D&C, it is important to continue treatment with anti-inflammatory medications and drugs that promote uterine contraction.

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Written by Du Rui Xia
Obstetrics
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Can you eat spicy food with late postpartum hemorrhage?

Women who experience late postpartum hemorrhage should not eat spicy foods. Spicy foods are not conducive to wound healing. Additionally, they may reduce the body's immune resistance, which could potentially lead to infections. Women who have postpartum bleeding should focus on a light diet and consume high-nutrition, easily digestible foods, such as eggs, milk, lean meat, fresh vegetables, and fruits, which can provide the necessary nutrients needed for postpartum recovery. Furthermore, appropriate physical activity is also beneficial for bodily recovery.

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Written by Liu Wei Jie
Obstetrics
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The difference between postpartum hemorrhage and menstruation

The difference between postpartum hemorrhage and menstruation varies whether it is a vaginal delivery or a cesarean section. The timing of postpartum bleeding varies, and it also relates to postpartum lochia. If the bleeding occurs within 24 hours, it is called severe postpartum hemorrhage; most frequently, we encounter bleeding after 24 hours. Typically, for vaginal deliveries, bleeding occurs within seven days. In cesarean sections, due to the uterine incision, healing is needed, and the duration of bleeding varies by individual and health, commonly lasting from one to two months post-operation. Postpartum bleeding is due to incomplete healing of the uterine lining, which is different from menstrual bleeding. Menstrual bleeding is usually heavier in the initial days and the blood is dark red with a cyclic pattern. In contrast, postpartum bleeding does not have a cyclic nature; it usually consists of fresh red or dark blood, whereas menstrual bleeding typically involves dark blood.

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Written by Liu Wen Li
Obstetrics
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Does postpartum hemorrhage affect appetite?

Postpartum hemorrhage can be significant, leading to anemia, which in turn affects appetite. After anemia occurs, the blood supply to the gastrointestinal tract is reduced, causing relative hypoxia and impacting the function of the gastrointestinal tract, thereby affecting appetite. If the postpartum bleeding is minimal and consists only of normal lochia, it generally does not affect appetite. Furthermore, whether postpartum hemorrhage affects appetite also greatly depends on individual differences. Regardless of its impact on appetite, postpartum recovery requires comprehensive and adequate energy intake to ensure physical recovery and milk secretion. Therefore, it is important to eat more and include a diet rich in protein and nutrients for better recovery.

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Written by Zhao Li Li
Obstetrics
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Can I eat donkey-hide gelatin after severe postpartum hemorrhage?

During the entire process of postpartum hemorrhage, it is still necessary to promptly understand the specific causes of the postpartum hemorrhage in order to treat the condition accordingly. Normally, after a major postpartum hemorrhage, it is first necessary to promptly ascertain the specific value of hemoglobin. If the hemoglobin is low, causing severe anemia, it is also recommended to promptly supplement with red blood cells or plasma to improve the blood condition of the body. During major postpartum hemorrhage, oral administration of donkey-hide gelatin can also have a very good regulatory effect on the body, achieving the effect of replenishing qi and blood.