I had a leek knife and had heavy bleeding during a natural birth.

I had a leek knife and had heavy bleeding during a natural birth.

Generally speaking, there is not much danger in lee knife surgery, and even if this surgical method is used for natural delivery, there will be no sequelae. However, some pregnant women experience heavy bleeding after this treatment. If this is the case, the situation will become very critical. You should stop the bleeding first to avoid excessive blood loss that may cause shock to the patient.

Placental bleeding

① Bleeding caused by retained placenta or residual placenta and fetal membranes: If the placenta has not been detached despite general treatment more than 30 minutes after the fetus is delivered, or if there is heavy bleeding, the placenta should be manually detached as soon as possible. The method is: re-disinfect the vulva, lay a towel, change gloves, enter the uterine cavity along the umbilical cord through the vagina with one hand, and after touching the edge of the placenta, slowly peel it off the uterine wall with your fingers. Use the other hand to fix the uterine fundus on the abdominal wall to cooperate with the operation. After the placenta is completely peeled off, hold it in your hand and slowly take it out with uterine contractions. After the placenta is delivered naturally or artificially removed, if there are any remnants of placental membranes, you can use a large scraper to gently scrape them off. If the placenta has been completely detached but is embedded in the uterine cavity and the cervix is ​​tight and contracted, it can be removed manually under anesthesia.

② Placenta accreta or placenta percreta: If the placenta has been confirmed to be accreta, do not forcefully clamp or curettage the uterus to avoid causing fatal postpartum hemorrhage. Depending on the size of the placenta implantation area and the conditions of the hospital, you can choose to use gauze to compress the uterine cavity, water bag to compress the uterine cavity, or ligation or embolization of the uterine artery or internal iliac artery to stop bleeding. If the bleeding is excessive and the above methods are ineffective, subtotal or total hysterectomy should be chosen in time to save the life of the mother.

Bleeding caused by coagulation dysfunction: The diagnosis should be confirmed on the basis of active treatment of the primary disease, and the corresponding coagulation factors should be supplemented promptly. ① Platelets: Used when the platelet count is lower than (20-50)×109/L or when uncontrollable bleeding occurs due to thrombocytopenia. ②Fresh frozen plasma: fresh anticoagulated whole blood is separated into plasma within 6 to 8 hours and quickly frozen, which preserves almost all coagulation factors, plasma proteins, and fibrinogen in the blood. ③ Cryoprecipitate: Infusion of cryoprecipitate is mainly used to correct the deficiency of fibrinogen. If the fibrinogen concentration is higher than 150 mg/dl, there is no need to infuse cryoprecipitate. ④Fibrinogen: Injection of 1g of fibrinogen can increase the fibrinogen level in the blood by 25g/L. 2~4g of fibrinogen can be injected at one time. ⑤Prothrombin complex.

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