Measures for postpartum hemorrhage

Written by Yue Hua
Obstetrics and Gynecology
Updated on September 16, 2024
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Postpartum hemorrhage refers to a situation where there is blood loss exceeding 500 milliliters within 24 hours after the birth of a child. Initially, massaging the uterus should be performed, as most of this bleeding is due to poor uterine contraction, and the doctor can press on the uterus from above the patient's lower abdomen. Additionally, high doses of uterotonic drugs can be used to induce uterine contraction. If these measures do not reduce bleeding, packing the uterine cavity with gauze can be employed to stop the bleeding from the uterus. Furthermore, if the bleeding is very severe, embolization of the uterine artery or the internal iliac artery can be done to halt the uterine bleeding.

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Written by Liu Wei Jie
Obstetrics
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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.

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Written by Yue Hua
Obstetrics and Gynecology
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Late postpartum hemorrhage clinical symptoms

Late postpartum hemorrhage occurs when significant uterine bleeding happens after the first 24 hours following the delivery of the fetus, commonly seen from one to two weeks postpartum. At this time, patients may experience sudden heavy vaginal bleeding, and some may even develop hemorrhagic shock. A minority of patients might not bleed profusely but may experience recurrent bleeding. Additionally, this bleeding is often accompanied by lower abdominal pain, fever, and symptoms of anemia, so it is critical to seek immediate medical treatment upon noticing these symptoms.

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Written by Du Rui Xia
Obstetrics
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How long is the critical period for postpartum hemorrhage?

Postpartum hemorrhage generally occurs within 24 hours after giving birth, and sometimes it can occur 1-2 weeks postpartum. It is important to pay special attention during this time to see if there is an increase in vaginal secretions or bleeding. Generally, after giving birth, it is necessary to observe in the delivery room for two hours; if there is no bleeding within those two hours, the patient can be moved back to the ward. The main causes of postpartum hemorrhage include poor contraction of the uterus, retained placental tissue, abnormalities in the coagulation function of the woman's blood, and tears in the birth canal.

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Written by Du Rui Xia
Obstetrics
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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.

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Written by Zhang Yin Xing
Obstetrics
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Does postpartum breastfeeding cause bleeding?

Bleeding caused by postpartum breastfeeding generally occurs within 42 days after delivery, during which the mother has lochia secretion. Breastfeeding promotes the secretion of oxytocin, which acts on the uterus and causes it to contract, facilitating the expulsion of lochia and aiding in the recovery of the uterus. Typically, by 42 days postpartum, the uterus has returned to its non-pregnant size and the expulsion of lochia is essentially complete. Subsequent breastfeeding is not directly related to vaginal bleeding. Another situation is due to the increase in prolactin during lactation; menstrual periods may not have fully resumed in women who are breastfeeding, and abnormal uterine bleeding may occur. As long as the amount and duration of bleeding do not exceed normal menstrual flow, no special treatment is needed.