Postpartum hemorrhage

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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.

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Written by Tang Mei Xiang
Obstetrics and Gynecology
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Postpartum hemorrhage causes

Postpartum hemorrhage (PPH) has four primary causes: 1. Lacerations from difficult labor; 2. Placental factors; 3. Uterine atony; 4. Coagulopathy. Immediately after childbirth, if there is bright red bleeding that includes blood clots, this is considered to be caused by soft birth canal lacerations. Approximately 10 to 15 minutes after delivery of the fetus, if significant bleeding occurs, placental factors should be considered. After the placenta is delivered, if the placenta and membranes are found to be intact and there is still vaginal bleeding, or if there is intermittent heavy vaginal bleeding, and the uterus feels soft and poorly defined upon light palpation, uterine atony should be considered as a likely cause of the heavy bleeding. Lastly, coagulopathy, which leads to continuous, dark red bleeding without clots, can also cause severe postpartum hemorrhage.

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Written by Du Rui Xia
Obstetrics
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Postpartum constipation and bleeding from the anus what's going on?

When constipation occurs after childbirth and there is anal bleeding, it may be due to fissures caused by constipation or hemorrhoids causing blood vessel rupture and bleeding. Postpartum, due to the reduced activity of the mother and the consumption of too refined foods, waste cannot be smoothly expelled, leading to difficulty in defecation due to fecal impaction. During straining, this might cause rupture of the anus or fissures, or lead to hemorrhoids by disrupting local blood circulation. It is advisable to go to the hospital for a check-up to see if it is serious, and if necessary, treatment to stop the bleeding may be required.

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Written by Zhao Li Li
Obstetrics
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What are the causes of postpartum hemorrhage?

Under normal circumstances, postpartum hemorrhage is one of the most severe complications that can occur during childbirth. Postpartum hemorrhage can be caused by several reasons: The first is mainly due to uterine atony leading to bleeding, which is relatively common and generally requires the administration of potent oxytocics to promote uterine contraction; The second is mainly due to local tears in the vagina or cervix leading to bleeding; The third is primarily caused by issues such as placental adhesion or implantation; The fourth is due to disorders in the body's coagulation function, leading to uncontrolled bleeding.

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Written by Zhang Lu
Obstetrics
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Symptoms of Postpartum Hemorrhage

Postpartum hemorrhage is the leading cause of death in pregnant women. The symptoms of postpartum hemorrhage include the following aspects: First, it initially presents as significant vaginal bleeding, where the bleeding may exceed 500 milliliters in a short period or 800-1000 milliliters within 24 hours, predominantly featuring fresh blood. Second, there can be abdominal pain or other symptoms caused by the underlying etiology, such as postpartum hemorrhage due to soft birth canal injuries, which can manifest as tears in the vagina or cervix. Third, there can be signs of shock, such as confusion, lowered blood pressure, and an increased heart rate, all of which are symptoms used to diagnose postpartum hemorrhage.

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Written by Du Rui Xia
Obstetrics
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How many days of postpartum bleeding are normal?

Postpartum hemorrhage typically stops around three weeks. Lochia can be classified into bloody lochia, serous lochia, and white lochia. Another type is abnormal bleeding, which is pathological bleeding. It occurs postpartum, for instance, due to soft birth canal injuries, cervical lacerations, uterine atony, or pre-existing blood disorders, which may extend the bleeding duration even beyond a month. This abnormal condition requires prompt medical attention. Normal lochia during the initial three to four days is bloody. As the bleeding from the uterus gradually decreases, it transitions to serous lochia, which can last about ten days. Finally, it becomes white lochia, which clears up after about three weeks.

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Written by Tang Mei Xiang
Obstetrics and Gynecology
1min 13sec home-news-image

Causes of postpartum hemorrhage

The causes of postpartum hemorrhage can be summarized into four main reasons: First is related to the placenta; second is lacerations in the soft birth canal; third is coagulation dysfunction; fourth is uterine atony, among which uterine atony is the most common cause. So, how can one determine if postpartum hemorrhage is caused by uterine atony? Clinically, after the placenta is delivered, examination of the soft birth canal is conducted. Upon examining the uterus, if it is found that the outline of the uterus is unclear and pressing on it results in a lot of blood and blood clots flowing out from the uterine cavity, then the uterus becomes firm when pressed and softens when not pressed. This situation indicates uterine atony. Other injuries, such as lacerations in the soft birth canal, are generally detected during an examination. There are also factors related to the placenta and coagulation dysfunction, which are the four main causes of postpartum hemorrhage.

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Written by Zhao Li Li
Obstetrics
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Postpartum hemorrhage patient care

During the process of postpartum hemorrhage, there are several considerations for the care of patients with postpartum hemorrhage. First, during the patient care process, it is necessary to closely monitor whether the contraction of the uterus is good, monitor the height of the uterine fundus, and the specific vaginal bleeding situation. Moreover, it is also necessary to provide a light and nutritious diet, avoiding spicy and irritating foods. Due to the massive bleeding caused by the surgical process, patients are generally weak, so it is recommended to rest more, avoid excessive fatigue, and also avoid looking after the newborn again to prevent various body disorders.

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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 Du Rui Xia
Obstetrics
42sec home-news-image

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.