Why is uterine curettage necessary for postpartum hemorrhage?

Written by Liu Wei Jie
Obstetrics
Updated on September 22, 2024
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We encounter a situation where postpartum hemorrhage is caused by the presence of residual material inside the uterus, which can influence the contraction of the uterus. This condition can lead to severe postpartum hemorrhage. The most important solution for postpartum hemorrhage is to immediately stop the bleeding. Therefore, by removing the residual material from the uterine cavity, the uterus can return to its normal contraction, achieving the purpose of immediately stopping the bleeding.

It is also very common to need uterine evacuation after childbirth, as this process might cause some trauma to the uterus. Although it can be somewhat traumatic, this trauma is minimal compared to severe postpartum hemorrhage. In such cases, we must carefully weigh the pros and cons and decisively decide to proceed with the evacuation of the uterus.

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Should the uterus be removed due to severe postpartum hemorrhage?

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.

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Written by Du Rui Xia
Obstetrics
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Postpartum Hemorrhage Prevention Measures

Postpartum hemorrhage can cause significant harm to a woman's body and, in severe cases, can even pose a threat to the patient's life. Therefore, it is crucial to implement preventative measures for postpartum hemorrhage. During prenatal check-ups, it is important to assess whether the pregnant woman has any risks for bleeding, such as checking if her coagulation function is normal. Additionally, it is essential to check for any serious comorbidities, such as hepatitis, renal failure, or other hematological diseases. These conditions should be treated before pregnancy. It is also advised to give birth in a reputable hospital, where the delivery can be conducted under the guidance of experienced doctors in a well-equipped facility. This can help alleviate the tension of the pregnant woman, contributing to a smoother delivery process. Moreover, within the first two hours after childbirth, careful monitoring of vaginal bleeding is necessary. If there is a significant amount of vaginal bleeding, timely hemostatic treatment should be administered.

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Written by Zhao Li Li
Obstetrics
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Can postpartum hemorrhage be stopped?

Postpartum hemorrhage primarily refers to bleeding from the vagina exceeding 500 milliliters within 24 hours after the delivery of the fetus, and bleeding exceeding 1000 milliliters for cesarean deliveries. It is classified as postpartum hemorrhage. Normally, active hemostatic symptomatic treatment should be pursued in cases of bleeding after childbirth. The majority of cases are often caused by poor uterine contraction, which significantly raises the likelihood of postpartum hemorrhage. Generally, it is necessary to actively use drugs that promote uterine contractions to help in reducing bleeding by aiding the contraction of the uterus.

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Written by Du Rui Xia
Obstetrics
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What should I do if I have postpartum anal fissures that bleed and cause pain?

When experiencing postpartum anal fissures, bleeding, and pain, it is important to use some medications locally to relieve pain and to promote smooth bowel movements. Traditional Chinese Medicine treatments can also be used for sitz baths or fumigation of the anal area. After the sitz bath or fumigation, some traditional Chinese topical medications can be applied; these are generally safe and do not affect breastfeeding women. Moreover, in daily life, it is crucial to drink plenty of water, engage in moderate activities, avoid lying in bed for long periods, and avoid consuming cold, spicy, or irritating foods. Instead, consume plenty of fresh vegetables and fruits to facilitate gastrointestinal motility.

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Written by Liu Wen Li
Obstetrics
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What is postpartum hemorrhage?

Postpartum, the endometrium in the uterus sheds, and the lochia is expelled. Typically, this blood flow is slightly heavier than a menstrual period. If there are blood clots, it indicates a higher amount of bleeding, or that the blood is not moving much. If the blood accumulates inside the uterus or vagina for too long without being expelled, it can form clots. The presence of small blood clots is not alarming, but if there are many clots, it is advisable to see a doctor to check if poor uterine contraction is the cause. An ultrasound can determine if there are any residuals. If poor uterine contractions and residuals are ruled out, increasing activity and promptly expelling the blood can be beneficial.