What to do if the uterus does not contract well and bleeds after childbirth

What to do if the uterus does not contract well and bleeds after childbirth

Within 24 hours after giving birth, women may experience bleeding due to poor uterine contraction. The amount of bleeding is generally around 500 ml. Postpartum hemorrhage must be taken seriously. Generally, you must closely observe whether there is any bleeding for about 3 hours after delivery. Severe bleeding can lead to shock or even maternal death. Generally speaking, postpartum hemorrhage can affect the pituitary gland of the mother, leading to hypopituitarism. The treatment methods are introduced below.

For bleeding caused by uterine atony, strengthening uterine contractions is the fastest and most effective way to stop bleeding. Eliminating the cause of uterine atony improves general condition, and catheterization relieves overfilled bladder. Uterine massage and abdominal massage of the uterus are the simplest and most effective way to induce uterine contraction to reduce bleeding. After the bleeding stops, intermittent and evenly rhythmic massage is still required to prevent the uterus from relaxing and bleeding again.

If necessary, you need to use both hands to massage the uterus. You can place one hand on the anterior vault of the vagina to press against the anterior wall of the uterus, and use the other hand to press the posterior wall of the uterus on the abdomen while massaging at the same time. The massage technique should be gentle and rhythmic. Avoid continuous excessive force for a long time, which may damage the uterine muscles and render the massage ineffective.

Oxytocin is the first-line drug for preventing and treating postpartum hemorrhage. The administration rate should be adjusted according to the patient's uterine contraction and bleeding conditions. Intravenous infusion can take effect immediately, but the half-life is short, so continuous intravenous infusion is required. If oxytocin receptors are oversaturated, they will not work, so the total amount should be controlled at 60U within 24 hours.

In fact, if postpartum bleeding is caused by poor uterine contraction, you can also use carboprost tromethamine for treatment. This is a derivative of prostaglandin that can coordinate uterine contraction after women give birth. However, please note that if you have asthma, you cannot use this drug. In addition, patients with hypertension cannot use this drug. This medicine can easily cause diarrhea, vomiting and nausea.

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