Postpartum hemorrhage

Postpartum hemorrhage

Postpartum complications: bleeding after childbirth

Bleeding after childbirthAn important role is played by ultrasound in the prevention of late postpartum hemorrhage (arising more than 2 hours after the birth of the placenta with all the membranes), since ultrasound can detect the remains of the placental tissue in the uterine cavity, pieces of membranes that are the main causes of these complications. This is a late postpartum period, i.e. about 6-8 weeks after delivery.

Early detection of changes in the uterine cavity with ultrasound examination allows you to put the correct diagnosis on time and prescribe the appropriate treatment. Such changes include:

  • presence in the uterine cavity of a large number of blood clots, the lack of dynamics of their secretion;
  • expansion of the uterine cavity (normal uterine cavity has a slit shape);
  • presence in the cavity of the remains of placental tissue and / or pieces of membranes;
  • inconsistency of the size of the uterus after the birth.

Bleeding in the puerperium occurs most often in the presence of residues in the uterus of the placental tissue, membranes. When the placenta is separated, the rupture of the uterine vessels that connect the uterus to the placenta occurs at the level of their constriction, where they have a spiral structure.

This feature of their structure allows the vessels to shrink and shift to deeper muscle layers, where they are subjected to additional compression from the muscular tissue of the uterus.

Simultaneously with these processes there is a thrombus formation in small vessels, leading to a stop of bleeding. In the normal course of the postpartum period, these processes occur simultaneously.

If the pieces of the placenta or membranes remain in the uterine cavity, they obstruct these processes and cause bleeding. This bleeding begins suddenly and at the same time is characterized by great blood loss. To prevent this complication is possible with the timely conduct of ultrasound, i.e. 2-3 days after delivery.

If an ultrasound examination for any reason was not conducted, and bleeding occurred after discharge from the maternity hospital, the woman should urgently consult a doctor. Usually, such postpartum bleeding occurs for no apparent reason, but may be associated with physical exertion, even insignificant, and also with sexual contact.

In this bleeding is abundant and is not accompanied by any painful sensations. Do not try to stop the postpartum hemorrhage yourself; at home, it is almost impossible.