Causes of Late Postpartum Hemorrhage

Written by Yue Hua
Obstetrics and Gynecology
Updated on September 16, 2024
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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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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.

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Written by Yue Hua
Obstetrics and Gynecology
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Postpartum Hemorrhage Emergency Response Process

Firstly, it is necessary to administer IV fluids to the patient and establish two venous accesses to urgently replenish blood volume. Then, it is important to manage breathing to ensure the patient's airway is clear, and provide oxygen if necessary. Patient's vital signs should also be checked for any abnormalities. Additionally, treatment should be given based on the cause of bleeding. If the bleeding is due to poor uterine contraction, it is crucial to promptly enhance uterine contractions to quickly stop the bleeding. At this time, uterotonic agents can be used, or manual uterine massage can be employed to stem the bleeding. If the bleeding is caused by a surgical incision, then the incision needs to be sutured properly.

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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 Du Rui Xia
Obstetrics
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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.

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Written by Du Rui Xia
Obstetrics
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Can you eat spicy food with late postpartum hemorrhage?

Women who experience late postpartum hemorrhage should not eat spicy foods. Spicy foods are not conducive to wound healing. Additionally, they may reduce the body's immune resistance, which could potentially lead to infections. Women who have postpartum bleeding should focus on a light diet and consume high-nutrition, easily digestible foods, such as eggs, milk, lean meat, fresh vegetables, and fruits, which can provide the necessary nutrients needed for postpartum recovery. Furthermore, appropriate physical activity is also beneficial for bodily recovery.