Methods of assessing postpartum hemorrhage

Written by Zhao Li Li
Obstetrics
Updated on January 26, 2025
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There are several methods to assess the approximate amount of bleeding when postpartum hemorrhage occurs. Normally, a curved dish can be placed at the vaginal opening after childbirth. By collecting blood in this curved dish, you can understand the specific amount of bleeding. Alternatively, the gauze method can be used, estimating the amount of bleeding based on the specific area of each piece of gauze. Another method involves monitoring changes in the patient's vital signs and using the specific timing of shock indices to determine the amount of bleeding. However, it is crucial to promptly implement hemostasis to avoid severe consequences.

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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 Zhao Li Li
Obstetrics
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Postpartum hemorrhage uterine suturing method

If postpartum hemorrhage occurs, it is foremost important to actively seek the specific causes of the bleeding to achieve timely and rapid hemostasis. It is also necessary to quickly replenish blood volume to prevent shock and infection. Meanwhile, if there is localized bleeding, active local suturing treatment should be pursued to control the bleeding. Normally, if the postpartum bleeding is light, suturing the uterus in the conventional way will suffice. However, if the bleeding is caused by uterine atony or similar reasons and oxytocics are ineffective, procedures like ascending ligation of the uterine arteries or uterine compression sutures and binding can be performed to effectively stop the bleeding.

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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 Zhang Lu
Obstetrics
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Is postpartum hemorrhage dangerous?

Postpartum hemorrhage refers to bleeding exceeding 500 milliliters within a short period after childbirth, or bleeding exceeding 1000 milliliters within 24 hours after childbirth. Postpartum hemorrhage is relatively dangerous because a large amount of bleeding in a short period of time after childbirth can cause the mother to experience hemorrhagic shock, and in severe cases, can lead to maternal death. Postpartum hemorrhage is currently the leading risk factor for maternal mortality. With increased understanding of the disease and improved treatment levels, the majority of postpartum hemorrhages can be managed successfully. The treatment of postpartum hemorrhage primarily involves early detection and early intervention. If symptoms of significant bleeding occur, it is essential to carefully identify the cause of the bleeding and provide targeted treatment. This can control the condition early and prevent worsening.

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Written by Zhao Li Li
Obstetrics
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How long will postpartum bleeding last until it stops?

Generally, in normal childbirth or after cesarean section surgery, there is usually a small amount of vaginal bleeding, which typically subsides completely within about a week. If there is heavy bleeding after delivery, it is crucial to closely monitor the vaginal bleeding to rule out the possibility of delayed postpartum hemorrhage. If the uterus contracts well and there is no retention of placental fragments, the area will generally be clean within about a week, albeit with some bloody discharge. Therefore, if there is abnormal vaginal bleeding postpartum, it is recommended to promptly re-examine to exclude the possibility of late bleeding, so as to avoid endangering life.