What is the difference between retained membranes and blood clots?

After a woman gives birth naturally or has an induced abortion, there will be some residual blood clots or residual fetal membranes inside the uterus. The long-term presence of residual substances in the uterus can easily lead to some gynecological diseases and have a great impact on women's physical health. There is a certain difference between the residual fetal membranes and blood clots. The fetal membranes are formed by chorionic tissue and appear fleshy, while blood clots are dirty blood and have no obvious physical objects.

What is the difference between retained fetal membranes and blood clots?

1. Composition of the fetal membrane: The fetal membrane is mainly composed of the amnion and the chorion. When the embryonic body folds are formed, the extraembryonic ectoderm and the extraembryonic body wall mesoderm surrounding the embryonic disc fold upward into the embryonic body, and finally converge on the dorsal side of the embryonic body to form the amnion, which encloses the fetus inside and the chorion on the outside.

2. During childbirth, as the fetus is delivered, its appendages such as the placenta, fetal membranes, and umbilical cord are discharged from the body. The doctor or midwife will routinely check the placenta to see if the fetal membranes are intact. If the placenta and fetal membranes are delivered intact, the uterus will contract well and there will be less vaginal bleeding. However, it is inevitable that some small fetal membranes will remain. Don't be afraid, this is normal and will generally be discharged with the lochia. However, if the fetal membrane is tightly adhered to the uterus and difficult to expel, it will affect the recovery of the uterus, manifesting as prolonged spotting or heavy bleeding. So how do you deal with this situation? First, you can take conservative treatment, such as taking motherwort capsules orally or injecting oxytocin intramuscularly to promote uterine contraction and expel the fetal membrane. Secondly, you can have a curettage, which is effective but relatively painful.

3. How do we judge whether what is discharged during the postpartum period is the fetal membrane or the blood clot? Generally, the fetal membrane is membrane-like and meat-like, and tissue can still be seen after washing with clean water; organized blood clots are generally dark red, and will break up after kneading or washing with water, with no obvious tissue.

4. No matter whether it is the fetal membrane or blood clots that are discharged, as long as the bleeding is not too much, you can observe it and don't need to be nervous.

Causes

It may be due to uterine malformation, uterine fibroids, intrauterine adhesions, etc., or it may be due to the unskilled operation operator, resulting in incomplete removal of the pregnancy tissue, causing some tissue to remain in the uterine cavity.

Clinical manifestations

If bloody lochia lasts for more than 2 weeks and the amount is large, it often indicates that the placenta attachment site is not restored well or there are residual placenta and fetal membranes. If the lochia is not clear one month after delivery and is accompanied by a foul or rotten odor, or is accompanied by abdominal pain and fever, it may be an infection of the vagina, uterus, fallopian tubes, or ovaries. If it is accompanied by heavy bleeding and the uterus is large and soft, it often indicates that the uterus is poorly restored.

examine

Gynecological examination, B-ultrasound examination, hysteroscopy, etc. can be performed.

diagnosis

1. Three weeks after delivery, red lochia is still discharged from the vagina.

2. If the lochia has a foul odor, or is accompanied by low fever, lower abdominal pain, poor uterine involution, or uterine tenderness, there is a uterine cavity infection.

3. When B-ultrasound examination shows that the uterus is poorly involuted and there is tissue in the uterine cavity, it is the placenta or placental residues.