What to do with early postpartum hemorrhage

In fact, the mother's emotions during the delivery process will also affect the uterine contractions after delivery, and uterine contractions will also cause bleeding symptoms. The mother needs to relax her emotions under the advice of the doctor. Uterine fibroids can also cause the risk of bleeding, so pregnant women with tumors in the uterus are best to have a cesarean section, which can not only ensure the health of the child and the mother but also remove the tumor. Ensure the health of the uterus! The treatment of bleeding depends on the mother's own constitution. If the mother has strong tolerance, there will be no sequelae after treatment. If the mother is weak, short-term heavy bleeding may be life-threatening.

Postpartum hemorrhage is divided into "early" and "late" according to the time of occurrence. The former occurs within 24 hours after the birth of the fetus; the latter occurs between 24 hours and six weeks after delivery. Early postpartum hemorrhage is the most common clinically and is more dangerous, so it must be treated immediately.

Common causes of early postpartum hemorrhage include poor uterine contraction, retained placenta, birth canal injury, implantation,

Placental and disseminated intravascular coagulation (dic) are several, among which poor uterine contraction is the main cause. in addition,

Pregnancy with uterine fibroids can also cause uterine contraction weakness. Pregnant women with multiple births have fibrosis of the uterine muscles.

The chance of poor uterine contraction after childbirth also increases. Dr. Zeng Chaoyang reminds that if you have had postpartum hemorrhage in your first pregnancy,

Women with this condition should be especially careful after their second pregnancy.

Reason 1: Poor uterine contraction

The so-called poor uterine contraction means that the mother's uterus cannot effectively contract, resulting in the placenta being attached to the placenta after delivery.

The vascular sinuses in the uterine wall cannot close, causing continuous heavy bleeding, which is common in cases of uterine weakness and multiple births.

Pregnancy, polyhydramnios, giant baby, use of large amounts of sedatives or anesthesia during labor, labor that is too long or too short,

Conditions such as administration of toxins.

If the mother's uterus does not contract well, the contractant can be injected through the blood vessels or directly into the belly, passing through the belly into the uterus. Uterotonics are a type of prostaglandin that can cause a woman to feel abdominal pain and hardness when breastfeeding a few days after giving birth. This is normal because the uterus is contracting. In addition to helping the uterus contract, breastfeeding also provides the baby with full nutrition from the mother for at least two months, which is highly encouraged.

Cause 2: Birth canal injury

Dr. Zeng Chaoyang said that mothers should be observed for at least two hours after delivery. If the uterus contracts well but bleeding continues, it may be due to birth canal injury. For example, in the case of a giant baby, if the baby's head is too big and the shoulders are too broad, it may cause tearing of the mother's birth canal. The perineum, vaginal wall and cervix may also be torn and need to be sutured immediately. As long as the stitches are smooth, there will be no bleeding.

Reason 3: Placenta retention

Another situation is retained placenta. Usually the placenta is delivered within half an hour after giving birth, but some doctors will start massaging the uterus ten minutes after giving birth. Once the uterus contracts, they will slowly pull the placenta out along the umbilical cord, and then cut it open to check whether it is intact. If there is missing or residual placental tissue attached to the uterine wall, it can also cause postpartum hemorrhage.

Cause 4 Placenta accreta

The relatively rare placenta accreta means that the placenta cannot be separated from the uterus after giving birth and is directly attached to the uterine muscle layer, which can cause continuous heavy bleeding. If the bleeding cannot be controlled and the mother has no plans to have children again in the future, the doctor will recommend a hysterectomy if necessary to ensure the health of the mother.

Rare uterine inversion

Uterine inversion is a very rare case, but it can also cause heavy bleeding after delivery. Because the placenta is pulled out along with the uterus after delivery, the uterus cannot contract and continues to bleed. At this time, the doctor will manually reposition it along the birth canal. If recovery is still not possible, surgery is required.

Cause 5 Disseminated intravascular coagulation (DIC)

Causes such as stillbirth, amniotic fluid embolism and severe placental abruption can lead to insufficient coagulation function and cause coagulation problems. Generally, blood will coagulate into a jelly-like form after about half an hour. However, if the blood flows for too long, the coagulation factors in the blood are insufficient and the blood remains liquid even for a long time. This is disseminated intravascular coagulation (DIC). Body fluids, blood and coagulation factors should be replenished immediately. Dr. Zeng Chaoyang said that the above situation will only occur if the mother continues to bleed or the blood transfusion is too slow. If medical staff can pay attention to the condition of the mother after delivery at the first time, it can be avoided.

Subtitle: Amniotic fluid embolism is the most critical!

One of the most critical situations on the delivery table is amniotic fluid embolism, which has a mortality rate of up to 80%. Dr. Zeng Chaoyang said that amniotic fluid embolism may be caused by the pressure during the delivery process, causing amniotic fluid to enter the lungs and block blood vessels, but there is currently no way to prevent it. When amniotic fluid embolism occurs, the mother will feel difficulty breathing and shortness of breath, and her face will turn black, her blood pressure will drop, she will bleed profusely, and her blood will not coagulate. It is common to occur about 5 minutes before or after delivery. About 20% of women in labor can survive after emergency treatment, but they may suffer from sequelae. Due to heavy bleeding, the blood does not carry enough oxygen, resulting in brain hypoxia. The anterior lobe of the pituitary gland is damaged due to hypoxia, causing neurological damage such as memory loss or anuria and amenorrhea.

Anuria: Heavy postpartum bleeding and sustained blood pressure below 80 mmHg may cause damage to the mother's renal tubules, resulting in anuria.

Amenorrhea: The pituitary gland is damaged due to lack of oxygen, resulting in endocrine disorders and amenorrhea in the future.

Lack of milk: Due to heavy postpartum bleeding, the mother lacks milk, but due to the lack of breastfeeding, the reflex stimulation of the uterus is reduced, making the uterus contract even more poorly.

I hope the above can give you a reference. A clear understanding of the occurrence of some things can ensure that the delivery process is smooth. The help of the doctor and the mother's own reasons are also important. Of course, there are many reasons for bleeding, among which amniotic fluid embolism is the most troublesome one. If not handled properly, the mother may be in danger of death. Giving birth in a regular hospital can ensure the health of the baby and the mother!