What does postpartum hemorrhage feel like?

Written by Yue Hua
Obstetrics and Gynecology
Updated on September 10, 2024
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Postpartum hemorrhage refers to the condition where, within 24 hours after vaginal delivery, the amount of blood loss reaches 500 milliliters, and in the case of a cesarean section, the blood loss amounts to 1000 milliliters. During this time, the woman may experience a substantial amount of bleeding from the vagina, along with large blood clots. The primary cause of this condition is often significantly associated with poor contraction of the uterine muscles. Post-delivery, the blood sinuses in the uterine muscle layer are open, requiring the uterus to contract. If the contractions are inadequate, it may lead to bleeding from these blood sinuses. Additionally, bleeding could also potentially stem from post-surgical wounds, such as those from a cesarean section or wounds from vaginal delivery.

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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 Liu Wei Jie
Obstetrics
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Does postpartum hemorrhage count as dystocia?

Postpartum hemorrhage is one of the very important causes that endanger the lives of mothers. Although hemorrhage is not considered as dystocia, conditions of dystocia can induce severe hemorrhage. This is because complications such as trauma to the birth canal and uterine atony might occur after dystocia. These issues are triggers for severe postpartum hemorrhage. Even in normal cesarean sections, there can be cases of severe postpartum hemorrhage, thus postpartum hemorrhage is not counted as dystocia, but dystocia can easily induce severe postpartum hemorrhage.

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Written by Liu Wei Jie
Obstetrics
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What are the warning signs of postpartum hemorrhage?

Postpartum hemorrhage generally does not have warning signs but usually has precipitating factors. These factors include maternal fear, psychological tension, macrosomia or twin pregnancy, as well as conditions like uterine fibroids, placental abruption, or placenta previa. In cases of placenta previa during a cesarean section, there is a high likelihood of severe bleeding. There is only one condition that might signal an impending postpartum hemorrhage, which is placental abruption. If placental abruption occurs, it can cause severe abdominal pain along with issues of hypertension during pregnancy. If a person with pregnancy-induced hypertension experiences severe abdominal pain, this could be a precursor to postpartum hemorrhage.

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Written by Liu Wei Jie
Obstetrics
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The most common cause of postpartum hemorrhage

Postpartum hemorrhage is divided into two scenarios. The first type occurs within 24 hours after childbirth and is seen in four situations. The first is due to inadequate uterine contraction, the second is trauma to the soft birth canal, the third concerns placental factors, and the fourth involves coagulation disorders. The second type of hemorrhage is late postpartum bleeding, which occurs one to two months after childbirth. This can be associated with postpartum infections, slow recovery of physical condition postpartum, retained products, and poor healing of cesarean section scars.

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Written by Zhao Li Li
Obstetrics
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Can postpartum hemorrhage be stopped?

Postpartum hemorrhage primarily refers to bleeding from the vagina exceeding 500 milliliters within 24 hours after the delivery of the fetus, and bleeding exceeding 1000 milliliters for cesarean deliveries. It is classified as postpartum hemorrhage. Normally, active hemostatic symptomatic treatment should be pursued in cases of bleeding after childbirth. The majority of cases are often caused by poor uterine contraction, which significantly raises the likelihood of postpartum hemorrhage. Generally, it is necessary to actively use drugs that promote uterine contractions to help in reducing bleeding by aiding the contraction of the uterus.