Can postpartum hemorrhage be stopped?

Written by Zhao Li Li
Obstetrics
Updated on September 21, 2024
00:00
00:00

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.

Other Voices

doctor image
home-news-image
Written by Yue Hua
Obstetrics and Gynecology
1min home-news-image

What does postpartum hemorrhage feel like?

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.

doctor image
home-news-image
Written by Tang Mei Xiang
Obstetrics and Gynecology
1min 15sec home-news-image

The main causes of postpartum hemorrhage

There are four main causes of postpartum hemorrhage: one is uterine atony, two is due to trauma in the soft birth canal, three is due to placental factors, and four is coagulation dysfunction. Uterine atony is the most common cause of postpartum hemorrhage clinically. Various factors can lead to uterine atony, such as maternal exhaustion during labor due to not eating, leading to physical decay, which can also cause uterine atony. Additionally, an excessively large uterus, such as from excessive amniotic fluid, twins, or triplets, can lead to poor uterine contraction and retraction rates after childbirth. As for injuries in the soft birth canal, they mainly occur due to insufficient protection of the perineum during childbirth or inappropriate use of vacuum assistance during the second stage of labor, causing trauma in the soft birth canal. Placental factors include placental adhesion, placenta accreta, partial placental abruption, and retained placenta, all of which can lead to postpartum bleeding due to placental issues.

doctor image
home-news-image
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.

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 Zhang Lu
Obstetrics
44sec home-news-image

Does postpartum hemorrhage require a blood transfusion?

The definition of postpartum hemorrhage is bleeding greater than 500 milliliters approximately 24 hours after vaginal delivery. Whether blood transfusion is necessary for postpartum hemorrhage mainly depends on the specific amount of bleeding. For average women, if the hemoglobin level is normal before delivery and the bleeding is between 500-1000 milliliters, the body can compensate for the anemia through normal adjustments, and generally, a blood transfusion is not required. However, if the bleeding exceeds 1000 milliliters, this situation is considered massive hemorrhage and must be treated with a blood transfusion, otherwise it may lead to hemorrhagic shock or DIC (Disseminated Intravascular Coagulation).