Treatment of late postpartum hemorrhage

Late postpartum hemorrhage refers to heavy uterine bleeding that occurs within the postpartum period 24 hours after delivery, with the amount of bleeding exceeding 500 ml. The most common onset is 1 to 2 weeks after delivery, but it can also occur as late as 6 weeks after delivery. The incidence of late postpartum hemorrhage is closely related to the quality of prenatal care and obstetrics. Children born by caesarean section are more likely to suffer from postpartum hemorrhage in their mothers. Let’s take a look at the treatment of late postpartum hemorrhage.

One cause

1. Cesarean section issues

Improper handling of cesarean section leading to uterine incision rupture is one of the important causes of late postpartum hemorrhage.

2. Weak uterine contractions

① Systemic factors: The mother is overly nervous and uses too many sedatives or anesthetics after delivery. ② Obstetric factors: prolonged labor or difficult labor, maternal physical weakness; obstetric complications, such as placenta previa, placental abruption, pregnancy-induced hypertension, combined acute and chronic systemic diseases, etc.

3. Overexpansion of the uterus

Such as twin pregnancy, macrosomia, and polyhydramnios.

4. Placental factors

Placenta previa, retained placenta, placenta adhesion, retained placenta and/or fetal membranes can all affect uterine contraction and lead to postpartum hemorrhage.

5. Soft birth canal laceration

Excessive uterine contractions, rapid labor, too large a fetus, failure to protect the perineum or vagina during delivery, improper surgical procedures, and poor elasticity of the soft birth canal tissue can all cause damage to the soft birth canal and lead to excessive blood loss.

6. Coagulation disorders

Primary or secondary coagulation abnormalities can cause postpartum hemorrhage.

Second treatment

1. Conservative treatment

Fluid replacement, anti-inflammation, hemostasis, correction of anemia, improvement of general condition, and partial healing of the incision are possible.

2. Surgery

If the blood supply of the tissues around the ruptured incision is good, the wound can be expanded and the necrotic tissue can be removed to form a fresh wound surface, which can then be sutured again. If erosion of the uterine incision and brittle tissue are found during laparotomy, and the lower transverse incision splits spontaneously and the upper and lower segments separate when the uterine fundus is pulled up, a total hysterectomy should be performed decisively, while anti-inflammatory treatment, blood transfusion, and correction of shock should be given.

After reading the above content, you will have some understanding of the causes and treatments of late postpartum hemorrhage. With the development of medical technology, the technology of childbirth is constantly improving, but the diseases caused by childbirth have not shown a downward trend, so the childbirth and recovery of the mother should not be taken lightly. We must always be prepared to guard, so we can definitely try our best to solve the problem of postpartum hemorrhage.