How much bleeding is considered postpartum hemorrhage?

Written by Yue Hua
Obstetrics and Gynecology
Updated on September 18, 2024
00:00
00:00

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.

Other Voices

doctor image
home-news-image
Written by Yue Hua
Obstetrics and Gynecology
49sec home-news-image

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.

doctor image
home-news-image
Written by Liu Wen Li
Obstetrics
53sec home-news-image

Does postpartum hemorrhage affect appetite?

Postpartum hemorrhage can be significant, leading to anemia, which in turn affects appetite. After anemia occurs, the blood supply to the gastrointestinal tract is reduced, causing relative hypoxia and impacting the function of the gastrointestinal tract, thereby affecting appetite. If the postpartum bleeding is minimal and consists only of normal lochia, it generally does not affect appetite. Furthermore, whether postpartum hemorrhage affects appetite also greatly depends on individual differences. Regardless of its impact on appetite, postpartum recovery requires comprehensive and adequate energy intake to ensure physical recovery and milk secretion. Therefore, it is important to eat more and include a diet rich in protein and nutrients for better recovery.

doctor image
home-news-image
Written by Liu Wei Jie
Obstetrics
1min 16sec home-news-image

The difference between postpartum hemorrhage and menstruation

The difference between postpartum hemorrhage and menstruation varies whether it is a vaginal delivery or a cesarean section. The timing of postpartum bleeding varies, and it also relates to postpartum lochia. If the bleeding occurs within 24 hours, it is called severe postpartum hemorrhage; most frequently, we encounter bleeding after 24 hours. Typically, for vaginal deliveries, bleeding occurs within seven days. In cesarean sections, due to the uterine incision, healing is needed, and the duration of bleeding varies by individual and health, commonly lasting from one to two months post-operation. Postpartum bleeding is due to incomplete healing of the uterine lining, which is different from menstrual bleeding. Menstrual bleeding is usually heavier in the initial days and the blood is dark red with a cyclic pattern. In contrast, postpartum bleeding does not have a cyclic nature; it usually consists of fresh red or dark blood, whereas menstrual bleeding typically involves dark blood.

doctor image
home-news-image
Written by Zhang Lu
Obstetrics
39sec home-news-image

Should the uterus be removed due to severe postpartum hemorrhage?

Whether postpartum hemorrhage requires hysterectomy primarily depends on the severity of the hemorrhage and the specific causes of the postpartum hemorrhage. First, if the amount of postpartum hemorrhage is very substantial, leading to conditions like DIC in the pregnant woman, and if not removing the uterus may cause ongoing bleeding, it is essential to remove the uterus quickly to reduce vaginal bleeding. Second, if the postpartum hemorrhage is caused by issues like amniotic fluid embolism or poor contraction of the uterus, and conservative treatments are ineffective, it is also necessary to make a prompt decision to remove the uterus.

doctor image
home-news-image
Written by Yue Hua
Obstetrics and Gynecology
46sec home-news-image

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.