Causes of Late Postpartum Hemorrhage

Written by Zhang Lu
Obstetrics
Updated on September 21, 2024
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Late postpartum hemorrhage refers to a significant amount of vaginal bleeding that occurs two to three weeks after a cesarean section or natural childbirth. The causes of late postpartum hemorrhage include the following aspects. First, the presence of residuals in the uterine cavity, such as when the placenta or membranes remain within the uterine cavity after childbirth, can repeatedly stimulate the endometrium causing bleeding. Second, poor healing of the uterine incision during a cesarean section can lead to post-cesarean bleeding, a condition that easily causes late postpartum hemorrhage. Third, poor healing of episiotomy or perineal laceration wounds after natural childbirth can also potentially lead to late postpartum hemorrhage.

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Written by Liu Wei Jie
Obstetrics
56sec home-news-image

Why is uterine curettage necessary for postpartum hemorrhage?

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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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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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.

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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 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.