Can postpartum hemorrhage be treated?

Written by Zhang Lu
Obstetrics
Updated on January 05, 2025
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Postpartum hemorrhage refers to bleeding exceeding 800 or 1000 milliliters within a short period after childbirth. It is currently the leading cause of maternal mortality in clinical practice. With the improvement of clinical treatment levels and the enhancement of diagnostic capabilities for postpartum hemorrhage, the vast majority of such cases can be well-managed. The keys to addressing postpartum hemorrhage effectively are early diagnosis and early intervention, which can lead to favorable outcomes. The main causes of postpartum hemorrhage include uterine atony, retained placenta and membranes, injuries to the soft birth canal, and coagulation disorders. When significant postpartum bleeding occurs, it is crucial to carefully investigate these four aspects to identify the cause and intervene accordingly, often leading to successful treatment outcomes.

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Written by Liu Wei Jie
Obstetrics
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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 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 Du Rui Xia
Obstetrics
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How long does it take to recover from postpartum hemorrhage?

Postpartum hemorrhage is a relatively common and serious complication clinically, but how long does it take to recover from postpartum hemorrhage? This depends on the physical condition of the mother. Typically, recovery takes about 4-6 weeks after delivery. Women with weaker constitutions may take longer to recover. When postpartum hemorrhage occurs, appropriate measures should be taken based on the cause. If there are lacerations in the birth canal, timely suturing is necessary. Additionally, if there is weak uterine contraction, medications that stimulate uterine contraction should be used to promote contraction and stop the bleeding.

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Written by Tang Mei Xiang
Obstetrics and Gynecology
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Causes of postpartum hemorrhage

The causes of postpartum hemorrhage can be summarized into four main reasons: First is related to the placenta; second is lacerations in the soft birth canal; third is coagulation dysfunction; fourth is uterine atony, among which uterine atony is the most common cause. So, how can one determine if postpartum hemorrhage is caused by uterine atony? Clinically, after the placenta is delivered, examination of the soft birth canal is conducted. Upon examining the uterus, if it is found that the outline of the uterus is unclear and pressing on it results in a lot of blood and blood clots flowing out from the uterine cavity, then the uterus becomes firm when pressed and softens when not pressed. This situation indicates uterine atony. Other injuries, such as lacerations in the soft birth canal, are generally detected during an examination. There are also factors related to the placenta and coagulation dysfunction, which are the four main causes of postpartum hemorrhage.

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Written by Du Rui Xia
Obstetrics
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Postpartum constipation and bleeding from the anus what's going on?

When constipation occurs after childbirth and there is anal bleeding, it may be due to fissures caused by constipation or hemorrhoids causing blood vessel rupture and bleeding. Postpartum, due to the reduced activity of the mother and the consumption of too refined foods, waste cannot be smoothly expelled, leading to difficulty in defecation due to fecal impaction. During straining, this might cause rupture of the anus or fissures, or lead to hemorrhoids by disrupting local blood circulation. It is advisable to go to the hospital for a check-up to see if it is serious, and if necessary, treatment to stop the bleeding may be required.