What should be done for late postpartum hemorrhage?

Written by Yue Hua
Obstetrics and Gynecology
Updated on September 20, 2024
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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.

Other Voices

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Written by Du Rui Xia
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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 Tang Mei Xiang
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The main causes of postpartum hemorrhage

There are four main causes of postpartum hemorrhage: one is uterine atony, two is due to trauma in the soft birth canal, three is due to placental factors, and four is coagulation dysfunction. Uterine atony is the most common cause of postpartum hemorrhage clinically. Various factors can lead to uterine atony, such as maternal exhaustion during labor due to not eating, leading to physical decay, which can also cause uterine atony. Additionally, an excessively large uterus, such as from excessive amniotic fluid, twins, or triplets, can lead to poor uterine contraction and retraction rates after childbirth. As for injuries in the soft birth canal, they mainly occur due to insufficient protection of the perineum during childbirth or inappropriate use of vacuum assistance during the second stage of labor, causing trauma in the soft birth canal. Placental factors include placental adhesion, placenta accreta, partial placental abruption, and retained placenta, all of which can lead to postpartum bleeding due to placental issues.

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Written by Liu Wei Jie
Obstetrics
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The most common cause of postpartum hemorrhage

Postpartum hemorrhage is divided into two scenarios. The first type occurs within 24 hours after childbirth and is seen in four situations. The first is due to inadequate uterine contraction, the second is trauma to the soft birth canal, the third concerns placental factors, and the fourth involves coagulation disorders. The second type of hemorrhage is late postpartum bleeding, which occurs one to two months after childbirth. This can be associated with postpartum infections, slow recovery of physical condition postpartum, retained products, and poor healing of cesarean section scars.

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Written by Zhang Lu
Obstetrics
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Can postpartum hemorrhage be treated?

Postpartum hemorrhage refers to bleeding exceeding 800 or 1000 milliliters within a short period after childbirth. It is currently the leading cause of maternal mortality in clinical practice. With the improvement of clinical treatment levels and the enhancement of diagnostic capabilities for postpartum hemorrhage, the vast majority of such cases can be well-managed. The keys to addressing postpartum hemorrhage effectively are early diagnosis and early intervention, which can lead to favorable outcomes. The main causes of postpartum hemorrhage include uterine atony, retained placenta and membranes, injuries to the soft birth canal, and coagulation disorders. When significant postpartum bleeding occurs, it is crucial to carefully investigate these four aspects to identify the cause and intervene accordingly, often leading to successful treatment outcomes.

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Written by Zhang Lu
Obstetrics
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Does postpartum hemorrhage require a blood transfusion?

The definition of postpartum hemorrhage is bleeding greater than 500 milliliters approximately 24 hours after vaginal delivery. Whether blood transfusion is necessary for postpartum hemorrhage mainly depends on the specific amount of bleeding. For average women, if the hemoglobin level is normal before delivery and the bleeding is between 500-1000 milliliters, the body can compensate for the anemia through normal adjustments, and generally, a blood transfusion is not required. However, if the bleeding exceeds 1000 milliliters, this situation is considered massive hemorrhage and must be treated with a blood transfusion, otherwise it may lead to hemorrhagic shock or DIC (Disseminated Intravascular Coagulation).