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Yue Hua
Obstetrics and Gynecology
About me
Undergraduate degree, associate chief physician.
Proficient in diseases
With over 30 years of experience working in obstetrics and gynecology, I have rich clinical experience and theoretical knowledge. I specialize in the prevention and treatment of common gynecological diseases, with extensive experience in the diagnosis and treatment of vaginitis, menstrual disorders, uterine fibroids, and polycystic ovarian syndrome. I have abundant clinical experience in prenatal care and various surgeries related to family planning (such as artificial abortion surgery, IUD placement and removal). I have a wealth of clinical experience in preoperative, intraoperative, and postoperative care, as well as unique insights into contraception and family planning.
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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.
How much bleeding is considered postpartum hemorrhage?
Postpartum hemorrhage refers to a condition where, if the patient has vaginal delivery, the bleeding exceeds 500 milliliters within 24 hours after the fetus is delivered. If the delivery is via cesarean section, the bleeding exceeds 1000 milliliters, which is considered significant postpartum hemorrhage. The primary cause is mostly related to poor uterine contractions. Due to inadequate muscle contractions of the uterus, the blood vessels in the uterine muscle layer remain open, leading to bleeding. Another cause relates to placental factors, such as when the placenta is not entirely expelled, leading to remnants of the placenta and membranes remaining in the uterine cavity, which can also cause postpartum bleeding.
Can premature rupture of membranes recover?
Premature rupture of membranes cannot be reversed. This means that the patient's membranes rupture before labor begins, and the ruptured membranes cannot be restored to their original, unruptured state. When the membranes rupture, most patients will feel fluid leaking from the vagina, and the patient does not experience abdominal pain or any sensation of being about to give birth; this is referred to as premature rupture of membranes. Upon discovering this condition, the first step is to have the patient rest in bed, as this situation can easily lead to the exposure of the fetal umbilical cord, which can endanger the child's life.
Symptoms of postpartum depression
The clinical manifestations of postpartum depression include patients feeling depressed, indifferent, and despondent about two weeks after giving birth. Additionally, patients may be reluctant to communicate with others, and might even avoid speaking to their spouses. Some mothers may also display a lack of confidence in life and family, decreased initiative, fatigue with life, slower reactions to things than usual, and reduced concentration. There is also a notable decrease in appetite, eating very little, and possibly experiencing symptoms like dizziness and headaches.
Premature birth is how many months?
Preterm birth refers to a newborn born between 28 and less than 38 weeks of pregnancy. Moreover, at this time, the heart size is generally more than 1000 grams. There are many reasons for this occurrence, most of which are related to intrauterine infection in pregnant women, such as patients with premature rupture of membranes or chorioamnionitis are prone to preterm birth. Additionally, if there has been a previous pregnancy, abortion, with a short interval between them, or if an ultrasound detects that the cervical length is less than 25 millimeters, there is also an increased likelihood of preterm birth.
How many days does the lochia last after a natural miscarriage?
Natural miscarriage generally cleans up the lochia in about a week. This is because natural miscarriage refers to the process where the embryo flows out from the uterine cavity on its own. Most people can completely clear out after a natural miscarriage, so the amount of bleeding is generally not very much, and the bleeding duration is not very long. If it is not clean after a week, it is necessary to consider whether it has not been completely cleared, and it is best to go to the hospital for an ultrasound to see if there are any issues with the uterus. Additionally, it is essential to rest and reduce activities after a natural miscarriage.
Causes of Late Postpartum Hemorrhage
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.
Measures for postpartum hemorrhage
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.
Can you have intercourse with endometrial polyps?
Endometrial polyps do not prevent sexual intercourse. This is because endometrial polyps are located within the uterine cavity, and sexual intercourse generally affects the vulva, vagina, and cervix. As long as these organs do not have any pathological changes, sexual intercourse is generally possible because the polyps inside the uterine cavity are not contacted during intercourse. Therefore, intercourse does not significantly affect the presence of polyps and can occur. However, if endometrial polyps are discovered, it is crucial to undergo early surgical treatment, which can be done through hysteroscopy or diagnostic curettage, as the polyps can grow larger over time.
Do uterine polyps require surgery?
Endometrial polyps require surgery. Patients with endometrial polyps generally have clinical symptoms, mainly characterized by irregular vaginal bleeding. This can be a small amount of bleeding after menstruation has ended, or extended periods during menstruation. In such cases, a hysteroscopy or diagnostic curettage is needed to remove these polyps. Relatively speaking, hysteroscopy is more accurate and has fewer side effects after surgery, but its disadvantage is the higher cost. The goal of both is to remove the endometrial polyps and then send them for pathological examination.