After giving birth, any woman should be prepared for spotting for another 42 days. Immediately they are represented by clots and blood, gradually the intensity decreases, and they acquire a mucous character. But postpartum period may become complicated. Often this is bleeding, which can pose a threat to the woman's life. What are the causes of such conditions, how to understand whether this is normal or pathological?

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Normal postpartum discharge

Normally, a woman has discharge from the genital tract - lochia - for six weeks (42 days). Intensity, consistency, color and other parameters undergo significant changes during this time. It roughly looks like this:

• The first hours after birth. The discharge is copious, often with clots. As a rule, at this time the woman is still lying down, resting, and a doctor and midwife are watching her.
• The first few days. Gradually, the discharge becomes smaller, and clots appear less and less often. At this time, the woman can safely use maxi. After breastfeeding there are more of them, as sucking stimulates uterine contractions.
• From approximately 7 - 10 pm spotting already have a spotting character and increase periodically.

• From the second week, the lochia becomes more mucous with streaks of blood. Occasional slight smudging also persists. At this time, even for several days, there may be no discharge, but then it appears again. This is an absolutely normal rhythm up to 42 days after birth inclusive.

If the discharge continues after six weeks, you should consult a doctor immediately. This is an alarming sign of possible pathology.

Periods of uterine bleeding after childbirth

Uterine bleeding - abnormal discharge blood from the uterine cavity. The issue is especially relevant in the postpartum period. At this time, due to some features of the discharge, the girl cannot always correctly assess its volume.

Uterine bleeding after childbirth can be divided into the following types:

• early, if they occur within 2 hours after birth;
• late – up to 42 days inclusive;
• after 42 days.

In the first case, the woman is still in maternity ward under the close supervision of obstetricians and gynecologists. Bleeding during this period is very massive and can even be life-threatening. Only a doctor or midwife can assess the nature of the discharge.

Late bleeding occurs due to various reasons. At this time, the woman is already at home, and if she suspects a pathology, she should consult a doctor.

Causes of the onset of postpartum bleeding

Causes of bleeding in early and late after birth period are somewhat different, as are the tactics of leading women.

Early postpartum bleeding

Such complications, if assistance is not provided in a timely manner, can lead to the death of a woman. Therefore, all actions of doctors must be polished, coordinated and fast. The main reasons for bleeding within two hours after childbirth are as follows:

Late postpartum bleeding

If bleeding develops within a few days after birth, then the causes may be the same factors that lead to a similar condition in early period. The further away very abundant lochia occurs, the higher the likelihood of some additional pathological process.

Late postpartum bleeding can also provoke the following conditions:

• Presence of placental. Its formation occurs from the remains of the child's place, if complete tissue rejection did not occur during childbirth. The placental polyp is small in size, but is almost always noticeable on a pelvic ultrasound.
• Development of the inflammatory process in the uterine cavity. It can be provoked by an infection in the vagina, chronic lesions (even carious teeth in immunodeficiency), etc.
• Hereditary features of myometrial contraction. This is the most harmless option for bleeding after childbirth. As a rule, in this case it goes away quickly with conservative treatment.
• Hydatidiform mole is a fairly rare pathology. It can be either benign or malignant. The discharge is often not abundant.

They are often more abundant than usual, painful and even clotted. But their duration should be no more than 3 - 7 days. In any case, the first critical days should not exceed the parameters of normal menstruation - approximately 20 ml of discharge per day.

Watch the video about uterine bleeding:

Symptoms of uterine bleeding after a month, in which you need to see a doctor

Immediately after giving birth, a woman is in the hospital for 3 - 5 or even more days. Doctors carefully monitor the nature of the discharge and, if pathology is suspected, immediately carry out additional examination and, if necessary, therapeutic manipulations.

Once a woman is discharged, she should monitor her condition independently. If the following situations occur, you should definitely seek medical help:

• If the discharge is very heavy, bloody (there is not enough maxi pad for an hour).
• When, for unknown reasons, they appeared.
• In the case when the lochia acquires a strange character - it becomes purulent.
• If the discharge continues for more than 42 days, even if it is not strong.

Diagnosis of the mother’s condition during uterine bleeding

If bleeding occurs, it is necessary to guess its cause as accurately as possible. Only in this case can the most correct therapeutic and diagnostic measures be taken.

With early postpartum hemorrhage, there is no time for any additional manipulations. Therefore, everything is immediately done to stop it. In this case, only the amount of blood that the woman has lost is assessed. This is of fundamental importance for the course of treatment measures.

Regarding late postpartum hemorrhage, it is necessary to clarify the reason why it occurred. Used following methods:

• . Using it, you can identify signs of inflammation, suspect placental polyp. It is also important to exclude new pregnancy, first menstruation and other pathology.
• Hysteroscopy, which is performed if a placental polyp or pathology of the uterine cavity is suspected.
• Usual RDV if no other examination is possible.
• Study of blood clotting abilities - coagulogram.

All received material is sent to histological examination. According to his conclusion, we can talk about the real reason bleeding.

Treatment of uterine bleeding after childbirth

Treatment for early and late postpartum hemorrhage is different. This is due to different character discharge and possible reasons for the development of such conditions.

Early postpartum bleeding

Based on possible reason and treatment is carried out. The sequence of actions is approximately as follows:

• Administration of drugs that enhance uterine contractility, for example, oxytocin.
• Manual examination of the uterine cavity. Allows you to identify parts of the placenta that prevent the myometrium from contracting. If necessary, manual massage is performed to increase the tone of the uterus (for atony).
• Inspection birth canal for ruptures and injuries. Stitches if necessary.
• If previous measures are ineffective, a complex of hemostatic actions is carried out: applying clamps to the vaginal vaults, repeating the administration of uterotonics and some others.
• If bleeding continues, the woman is transferred to the operating room. An intervention is carried out, the volume of which depends on many factors. This may be the application of special compression sutures to the uterus to compress it, and other methods. If necessary, the organ is removed, which is last hope to save the woman.

Late uterine bleeding after childbirth

Treatment of late bleeding in most cases begins with conservative measures. These are contractile drugs, antibiotics, hemostatics, etc.

As a rule, after performing a pelvic ultrasound, it becomes clear whether curettage or hysteroscopy is necessary. It is performed if there is a suspicion of placental remnants or hydatidiform mole. The resulting material is sent for histological examination.

Prevention of postpartum hemorrhage

No woman can be immune from such bleeding, even if she has already had a successful uncomplicated birth. Therefore, everyone, without exception, receives prophylaxis in the early postpartum period. It includes the following:

• Excreting urine with a catheter to overflow bladder did not prevent the uterus from contracting.
• Cold on the lower abdomen for an hour or two for 20 minutes with breaks.
• Risk groups (large fetus, history of bleeding, etc.) are given contractile agents, usually oxytocin.

After discharge from the maternity hospital, a woman should also take care of her health. To prevent bleeding, the following is recommended:

• Practice breastfeeding.
• Observe sexual rest from 2 - 3 weeks to 2 months, depending on the complexity of childbirth.

Bleeding after childbirth is a serious, sometimes life-threatening condition for a woman. Only timely and qualified medical care will help remove its cause and save the young mother. The woman’s task is to contact specialists in time and follow all advice after childbirth.

After childbirth, pregnancy is replaced by new period– postpartum, perhaps, is no less, and sometimes even more, complex than pregnancy. Many women who are busy caring for a newborn child do not pay attention to their own problems, considering them something insignificant. This negligence may subsequently result in serious complications with health. But they can be prevented.

What is the postpartum period?

The postpartum period begins immediately after the birth of the placenta and lasts approximately 6-8 weeks. During this time physical condition women are still far from normal. The uterus, which weighs about 1 kg after birth, is almost a continuous wound.

In an effort to return to its normal state, the uterus will constantly contract, as a result of which its size will gradually decrease. In addition, the uterus strives to cleanse itself, this happens by postpartum discharge, which are called lochia.

During the postpartum period, the discharge continues for approximately 6-8 weeks, during which time the uterus returns to its normal size. If a woman does not breastfeed, her body begins to function as before, that is, she begins to menstruate. During the postpartum period, discharge can be quite painful. To avoid complications, it is necessary to create favorable conditions for discharge, so that the uterus contracts unhindered and lochia is released freely. If something interferes with this process, the likelihood of bleeding and infection of the uterus increases, and these are complications that have to be treated in a hospital.

What causes the uterus to contract? Mainly, of course, breastfeeding. At first, when the baby begins to suck, the mother feels something similar to contractions, accompanied by throbbing pain in the lower abdomen. The discharge begins to intensify, blood clots appear - these are completely normal phenomena.

The second factor contributing to more rapid reduction uterus - this is the timely emptying of the bladder and intestines. For the first few days after giving birth, it is advisable for a woman to lie on her stomach more often - this promotes the outflow of lochia.

If during the postpartum period bleeding ends by the 8th week and does not bring the woman discomfort, which means everything is happening as expected. Usually, by the seventh day, the discharge becomes more scanty, the blood content in it decreases, it becomes light pink, and then completely whitish, mucous - and so on until it disappears completely.

It has been proven that in women who breastfeed, bleeding in the postpartum period ends faster. If the child was born through caesarean section– on the contrary, everything happens more slowly.

In what cases should you consult a doctor?

You should immediately contact a specialist if the discharge becomes purulent or has bad smell, and after pink ones, bloody discharge bright red started again. All these signs indicate complications that will not disappear on their own, but will bring a lot of trouble if you do not seek help from a doctor.

Bleeding in the early postpartum period that lasts more than 15 days should be a concern.

What else should you be wary of?

Must be adhered to strict rules personal hygiene: wash thoroughly after each visit to the toilet, especially if you have postpartum sutures. Many doctors recommend using baby soap for these purposes, or even better, as strange as it may sound, household soap, the most common, brown soap. This kind of soap will help dry the skin well without causing an allergic reaction.

In addition, after each visit you need to change the pad - at least every 4 hours. These measures will allow you to protect yourself by 90% from various complications.

During the entire postpartum period, you should not douche or use vaginal tampons. This is a very serious warning - this is the easiest way to get an infection! The gynecologist also strives to protect you from infections and prohibits you from having sex during the postpartum period. Sexual contact is one of the shortest ways to “catch” an infection.

In general, you should be extremely careful when starting sexual relations after childbirth. The fact is that a woman’s mucous membranes remain vulnerable and overly sensitive for a long time, and sexual intercourse may not give her the most pleasant sensations. At first, you should definitely use a condom, preferably with lubricant - it will help moisturize the vagina, thereby reducing painful sensations women, and in addition, it will protect the woman from various infections, which in a normal, “prenatal” state, would not cause the slightest concern.

Postpartum problems

All the difficulties that await a woman after childbirth can be divided into serious problems and "little things". However, serious complications usually require hospital treatment. However, it is a mistake to think that “little things” can be ignored. If you don’t “deal with” them right away, they can bring a lot of grief in the future.

Factors that may contribute to the development of postpartum hemorrhage:

– Excessively distended uterus – as a result of multiple pregnancy or a large fetus.
– Difficult long labor.
- Polyhydramnios.
– Non-contracting uterus – this happens due to long labor contractions.
– Separating the child seat too quickly.
- Uterine ruptures.
– Uterine prolapse.
– Vaginal lacerations.
- Remains of placenta in the uterus.
– Maternal blood clotting disorder. This may be a congenital anomaly, or it may be a consequence of taking certain medicines, for example, aspirin.

Bleeding in the postpartum period: prevention

To prevent complications associated with postpartum hemorrhage as much as possible, it is necessary to carry out qualified preventive measures. That is why during pregnancy a woman has to take many tests. various analyzes blood. Doctors examine the number of leukocytes, platelets and red blood cells, bleeding time, blood clotting time, hemoglobin level... If any pathology is detected, the doctor prescribes a number of special preventive measures for the pregnant woman.

Such expectant mothers belong to the group increased risk development of bleeding during childbirth or in the postpartum period. Ideal option– if a woman in labor ends up in a special maternity hospital specializing in medical care women with blood diseases. If the doctor deems it appropriate, the woman is given a transfusion of her own blood, taken from her in advance.

In addition, immediately after childbirth, women are given special drug, which should speed up uterine contractions and, therefore, reduce the time of postpartum bleeding.

In some cases, bleeding may be more bothersome long period or resume. In such a situation, it is better to consult a specialist, but if it is not possible to visit a doctor in the near future, then you need to try to solve the problem yourself.

Why can a hole bleed for a long time after tooth extraction?

The cause of bleeding after surgery is injury blood vessels gums, mucous membrane, soft tissues of the jaw and even bone. This is primary cause bleeding.

TO secondary causes include:

• The end of the action is with adrenaline in the composition, which constricts all blood vessels except the heart and brain.
• Hypertension is accompanied by increased blood pressure and, accordingly, can cause bleeding. It is strictly forbidden to carry out the procedure during an exacerbation of the disease.
• Bleeding disorders.
• Taking hemolytic drugs that thin the blood.
• Damage to large vessels.
• Traumatic tooth extraction surgery.
• Inflammation of soft tissues in the area of ​​removal.
• Wide mouth opening.
• Failure to follow doctor's recommendations.

How long should bleeding normally take after tooth extraction?

Many people are concerned about the question: how much there's blood coming out after tooth extraction? In the absence of diseases of the patient and a normally performed operation, blood flows normally for 10–15 minutes after tooth extraction, with some complications up to 30–40 minutes. In such cases, the dentist uses various medications and mechanical means. In any case, the bleeding should be stopped by visiting a doctor.

After the operation, a tooth socket remains with or without a blood clot. A blood clot after tooth extraction is normal reaction organism, a prerequisite for good healing wounds. Therefore, it is forbidden to suck blood from the wound, spit and rinse the mouth for several hours.

If bleeding resumes at home, this is a sign of problems and requires specialist intervention. At heavy bleeding need to call ambulance, with a little under-roofing, you can try to stop the bleeding yourself.

In what cases should you consult a doctor?

It is necessary to seek medical help in the following cases:

• the appearance of heavy bleeding;
• inability to stop bleeding for more than an hour;
• the occurrence of weakness, headache, dizziness;
• pain when touching the gums;
• swelling or swelling of the jaw area;
• increase in temperature;
• discharge of blood mixed with pus;
• acute pain.

Ways to stop bleeding after tooth extraction

Bleeding after tooth extraction is a well-known symptom. How to stop bleeding after tooth extraction?

To stop the process, you need to mechanically or medicinally influence the bleeding vessels; various methods are used for this:

• Tamponade - one of the most effective and popular methods that helps both stop bleeding after tooth extraction and stop other types of bleeding (nose, ear). To do this, apply a sterile swab made of bandage or gauze to the required area, squeeze the edges of the hole and ask to bite without excessive pressure. In this case, mechanical pressure occurs on the vessels, during which they stick together and do not bleed. It is recommended to hold the tampon for 15–20 minutes.
• Applying a tampon with 3% hydrogen peroxide . To do this, moisten a tampon in an antiseptic and apply it to the wound for 20 minutes. Peroxide has a clotting effect on the blood.
• Using a hemostatic sponge . The sponge is an excellent professional medication, which can also be used at home. To do this, a small piece of material is placed in the hole. extracted tooth Using tweezers, place a cotton swab, gauze or bandage on top and close the teeth. The hemostatic sponge begins to act instantly. If it was not possible to stop the bleeding in this way, it means that the sponge was soaked and did not have time to act, the procedure for applying the product must be repeated.
• Cold compress . The effect of cold on blood vessels slows down and stops bleeding. It is recommended to apply cold to the area where surgery was performed. To do this, use ice, frozen foods, or any cold object at hand. To avoid damage skin It is recommended to wrap the cold in soft cloth. You need to apply the compress for no more than 5 minutes, after another 5 minutes you can repeat the procedure.

At home

Several ways to stop bleeding after tooth extraction at home:

• Apply a clean bandage or gauze to the wound for 15–20 minutes and squeeze your teeth tightly.
• Apply a swab moistened with hydrogen peroxide to the desired area for 20 minutes and press.
• Do cold compress using ice, frozen foods, or refrigerated means at hand. The procedure can be carried out for 15–20 minutes with breaks every 5 minutes.
• Overlay hemostatic sponge. This medicine can be bought at any pharmacy. To apply the sponge correctly, you need to cut off a small piece, dry the wound and put the product in the jaw socket for 15 minutes.
• If the wound is slightly bleeding, rinses and oral baths with decoctions can be performed. medicinal herbs. Herbs have anti-inflammatory, hemostatic, wound healing, regenerative and other beneficial properties. Apply medicinal decoctions with chamomile, sage, oak bark, calendula, nettle. Use a decoction at room temperature for rinsing, irrigation, and mouth baths 5–6 times a day.

In addition to these methods, you need to know what to do at home. First of all, you need to lie down, calm down, try to relax. You need to measure your blood pressure and take an antihypertensive drug if it increases.

Methods to stop bleeding can be combined, so when applying a tampon, you can apply a cold compress. If there are no results for more than 1–1.5 hours, you need to call or visit the doctor who removed the tooth, or go to the nearest dentist.

At the dentist's office

To stop bleeding, the dentist performs the following manipulations:

1. Cleans the alveolar socket.
2. Checks the socket of the extracted tooth for remains of fragments.
3. Treats the wound with antiseptics.
4. Places a tampon.

If the bleeding does not stop within 15–20 minutes, the following methods are used:

• application of hemostatic agents - sponge, fibrin film with albucid or fibrin, caprofer, aminocaproic acid, kollapan;
• application of iodoform turunda;
• injection of hemostatic agents;
• compression of the surgical area;
• suturing - performed only when bleeding has completely stopped to prevent complications;
• ligation of blood vessels - performed when large vessels are damaged;
• electrocoagulation is a procedure in which blood vessels are cauterized. The procedure is effective for hypertension, blood diseases, and poor clotting.

Patients who have had a long period of pain or discharge large quantities blood, medications are prescribed (dicinone). With increased blood pressure It is recommended to take a blood pressure lowering drug.

If the patient uses hemolytic blood thinners, you need to refrain from using them for several days. Patients are advised to rest, abstain from physical activity, visits to the bathhouse, a repeat prophylactic appointment is prescribed.

What can't you do?

After surgery, the doctor gives patients recommendations that must be followed postoperative period.

To prevent the occurrence of various complications, it is recommended:

• remove the gauze pad after 20 minutes;
• stop smoking and drinking alcohol;
• do not rinse the mouth on the day of removal;
• do not suck out or remove the blood clot from the socket;
• You cannot brush your teeth on the extraction side for 12 hours;
• refrain from eating hot, cold, spicy and solid foods;
• you cannot visit the bathhouse, sauna or take a hot bath;
• you can’t play sports;
• you need to refrain from strenuous physical activity.

Prevention measures

Preventive measures are aimed at preventing secondary bleeding of the wound and complications in the form of inflammation of the socket. To do this, the dentist and the patient must adhere to certain rules.

Prevention for the doctor consists of collecting the patient’s medical history, determining the state of health and the presence of diseases, carefully removing teeth, stopping bleeding and recommendations to the patient in the postoperative period.

Preventive measures for the patient include: warnings from the dentist about diseases (blood, hypertension), about taking medicines, about the state of health. After surgery, the patient must carefully follow the doctor’s instructions, not skip medications, and carefully perform hygiene care for the organs of the oral cavity.

It can be concluded that bleeding after tooth extraction is a common symptom. If a complication occurs, safe and effective ways stop bleeding. If the rules of prevention are strictly followed, the postoperative period will be easy and without complications.

Useful video about what happens after tooth extraction

Bleeding after childbirth is a normal physiological process. It allows female body return to its previous state: the uterus is cleansed of placenta, lochia and pieces of placenta. The discharge begins immediately after the birth of the child and continues for about a month and a half.

But sometimes this process becomes pathological. The main criterion for its assessment is the nature and volume of blood loss. Women on later During pregnancy and for those who have recently given birth, it is especially important to know what kind of bleeding is considered normal and what measures to take to prevent complications.

The question is how long does it last? postpartum hemorrhage, occurs in almost all young mothers. The duration of this process can be from 2 to 6 weeks or even a little more. The duration depends on several factors: the ability of the uterus to contract, blood clotting, the rate of tissue regeneration, etc. In women who are breastfeeding, recovery occurs faster.

It is important to evaluate not only the duration of bleeding, but also general character: They should gradually become less abundant. In the first day after birth, the discharge is strong, then it becomes less and less and eventually turns into a brownish “smudge.” This sequence is the norm.

Causes of bleeding after childbirth

Abundant abnormal bleeding in the early postpartum period, lasting about 2 hours after the birth of the child, caused by the following reasons:

1. Insufficient blood clotting. With this complication, it flows out in a stream without the formation of clots and lumps (thrombosis disorder). To prevent the situation, before giving birth it is necessary to donate blood for general analysis, discontinue all drugs with anticoagulant effects.
2. Rapid labor activity. It is accompanied by ruptures of the birth canal: the cervix, vagina, and in rare cases- uterus.
3. Placenta accreta. With this complication, the reverse development of the uterus is difficult, which leads to heavy bleeding.
4. Insufficient ability of the uterus to contract. Most often this happens when the walls are greatly stretched (,);
5. The presence of fibroids and myomas in the uterus.

The causes of postpartum hemorrhage in the period from 2 to 6 are:

1. The release of placenta particles remaining in the uterine cavity.
2. Exit blood clots, difficult due to spasmodic contraction of the cervix after surgical delivery (caesarean section).
3. Slow recovery due to inflammation in the pelvic area (high fever is also noted).

Features of postpartum hemorrhage

Symptoms of postpartum hemorrhage can be described in two parameters: the volume and nature of the discharge. It is also possible to violate heart rate, changes in arterial and venous pressure, deterioration in general health.

A blood loss of 0.5% or less of a woman’s body weight is considered physiologically acceptable. If this indicator is higher, then pathological postpartum bleeding is diagnosed. Massive blood loss is its release in a volume of 0.5 to 1% of the mother’s weight. At the same time, it may decrease blood pressure, weakness and dizziness appear.

When the rate exceeds 1%, critical blood loss develops. It may be accompanied by hemorrhagic shock and DIC (coagulation disorder). These complications lead to irreversible changes in organs.

Heavy postpartum bleeding develops with decreased or absent uterine tone. The more pronounced the atony, the worse it responds to therapeutic measures. Drugs that cause myometrial contraction eliminate bleeding only for a while. The condition is accompanied arterial hypotension, tachycardia, pale skin, dizziness.

Diagnostic procedures

The diagnostic process begins during pregnancy. In modern obstetric and gynecological practice, assessment of the risk of postpartum hemorrhage is based on data from monitoring changes in the level of hemoglobin, red blood cells, platelets in the blood on different dates gestation. Coagulability indicators (coagulogram) are taken into account.

Hypotonia and atony of the uterine muscles are diagnosed in the third period labor activity. These conditions are indicated by flabbiness and weak contractions of the myometrium, an increase in the time of the afterbirth stage.

Diagnosis of bleeding after childbirth includes a thorough examination of the integrity of the released placenta, membranes, examination of the birth canal to identify possible injuries. If necessary, the woman is given general anesthesia and the doctor manually examines the uterine cavity to determine if there are ruptures, placenta, blood clots, malformations, or tumors that may interfere with myometrial contraction.

For bleeding in the late postpartum period, diagnosis is carried out using ultrasound. On the 2nd or 3rd day after the birth of the child, the condition of the pelvic organs is examined. The procedure allows you to identify the remains of the placenta and membranes in the uterus.

Normal bleeding after childbirth

Normal bleeding in the postpartum period is caused by the release of remnants of the placenta and membranes from the uterus. This process is divided into several periods, each of which is characterized by certain characteristics: color and intensity of discharge.

The first three days after the birth of a child, bleeding is profuse, the volume is more than during menstruation. Color - bright red. Blood comes out of those vessels that were at the placenta attachment site. This condition develops due to insufficient contractility of the uterus in the first days after childbirth. It is considered normal and does not require medical intervention. Postpartum bleeding after a cesarean section may be longer because the incised uterus contracts less well.

Over the next two weeks, the intensity of discharge decreases noticeably. They turn light pink, brown or yellowish white. The uterus gradually contracts, and by the end of the second week the bleeding completely disappears. This option is considered the norm.

In some cases, bleeding is observed in the late labor period. It can be either normal or pathological, requiring medical intervention. If, in the period from 2 to 6 weeks after the birth of the child, light discharge from the uterus with impurities of blood appears, then there is no need to worry. This symptom may be present constantly or may appear and disappear for several days. This intermittent regime is typical for women who quickly return to sports training or other physical activity.

Sometimes the bleeding disappears by the end of the second week, and then appears for a few days between 3 and 6 weeks after birth. The discharge is insignificant and painless and is normal.

Pathological bleeding after childbirth

A deviation from the norm that requires the help of a doctor is late bleeding with the following features:

• duration more than 6 weeks;
• scanty discharge with ichor is replaced by scarlet blood;
• the woman’s general condition becomes worse;
• bleeding is accompanied by pain in the lower abdomen;
• signs of intoxication appear (fever, dizziness, nausea, etc.);
• The discharge becomes brown or yellow-green in color and has an unpleasant odor.

If there is an intense flow of blood, especially if it is scarlet, you should immediately call an ambulance. Pain, fever, change in color of discharge indicate the development of complications: infectious diseases, etc. Such conditions require as much as possible early diagnosis and treatment.

Treatment methods

Acute postpartum hemorrhage requires first of all establishing its cause, as well as prompt cessation. Used in treatment integrated approach and often drug therapy must be combined with invasive methods.

To stimulate contractile activity uterus, a catheter is inserted into the urethra to empty the bladder, and bottom part ice is applied to the abdomen. Sometimes gentle external massage of the uterus is performed. If all these procedures do not bring results, then uterotonic drugs, for example, Methylergometrine and Oxytocin, are administered intravenously, and injections with prostaglandins are given into the cervix.

Replenishing the volume of circulating blood and eliminating the consequences of its loss is carried out using infusion-transfusion therapy. Plasma replacement drugs and blood components (primarily red blood cells) are injected into a vein.

If, upon examination using mirrors, ruptures in the birth canal and perineum are detected, then local anesthetic, and the doctor stitches up the damage. Manual examination and manual cleansing of the uterus is indicated for violations of the integrity of the placenta and hypotonic processes in the myometrium. The procedure takes place under general anesthesia.

If a uterine rupture is detected during a manual examination, then emergency laparotomy, suturing or complete removal uterus. Surgical intervention It is also required for placenta accreta and in cases where the bleeding is massive and cannot be stopped. Similar procedures are carried out with simultaneous resuscitation actions: blood loss is compensated, hemodynamics and blood pressure are stabilized.

Preventive measures

Prevention of postpartum hemorrhage helps reduce its duration and intensity, and also avoid complications.

It involves implementing the following recommendations:

• go to the toilet regularly: a full bladder and intestines put pressure on the uterus and prevent it from contracting;
• do everything possible measures to prevent infection of the uterine cavity: follow the rules intimate hygiene, do not swim in open water, refrain from sexual intercourse and bathing;
• do not engage in sports or other intense physical activity for one and a half months;
• develop the habit of sleeping lying on your stomach, so the uterus contracts and cleanses faster;
• breastfeed the baby;
• avoid overheating: do not visit baths, saunas, or be outside on a hot day.

Bleeding after birth is normal physiological process, which still needs to be controlled. It is important to pay attention to the duration, intensity and nature of the discharge. If you suspect complications, you should see a doctor as soon as possible, and if intense scarlet bleeding appears, call an ambulance.

Useful video about the postpartum period

Postpartum hemorrhage may result from gynecological diseases elements of the placenta remaining in the uterus, weak or absent contractility of this organ.

What are the reasons for bleeding after childbirth?

Bloody discharge in women after the birth of a child appears due to damage to blood vessels at the site of attachment of the placenta to the walls of the uterus. The contractile movements of this organ help the body get rid of the remnants of the “children’s place” and restore its previous size. Normally, bleeding after childbirth can last from 2 to 6 weeks, but it also happens various pathologies accompanied by heavy loss of blood.

How long does bleeding last after childbirth, and? Women often turn to their gynecologist with such questions. It is considered normal if blood loss lasts no more than 6 weeks. On average, about 1.5 liters of blood can be released.

How long postpartum bleeding lasts depends on how the baby is fed. During lactation, the uterus contracts much faster, and restoration of its size accelerates. This helps to quickly stop the discharge.

The duration of bleeding in the postpartum period is influenced by the following features:

• previous caesarean section;
• excessive physical activity;
• stress;
• weak contractility of the uterus;
• presence of gynecological diseases;
• inflammation caused by placental remnants;
• application of internal sutures;
• malposition;
• bleeding during childbirth;
• poor blood clotting;
• taking anticoagulants;
• the birth of a large child;
• extensive trauma to the birth canal;
• placental polyp.

The first 2-3 days after birth, the discharge is bright red with clots, quite intense. This is a sign of lochia, which is the discharge of the wound secretion of the uterus. Gradually, the intensity of the discharge decreases; tissue fluid, decidua cells and mucus are added to the secretion.

From about 4 days the blood flows less strongly, its color changes to red-yellow, and later the substance acquires a brown tint. By the end of 5–6 weeks, a clear, ichorous secretion is released.

Symptoms of early menorrhagia

Postpartum hemorrhage is a heavy loss of blood, which amounts to 0.5% of the body weight of the woman who gave birth. Severe blood loss that began immediately after the placenta came out or during the first 2 hours is called early. This condition applies to postpartum complications and can lead to serious consequences.

Why does bleeding develop in the early postpartum period? The reasons are:

• decreased tone, uterine paralysis;
• taking anticoagulants, antiplatelet agents;
• birth injuries of the vagina, body and cervix, pelvic joints;
• uterine rupture;
• accreta or malpositioned placenta;
• incorrect suturing;
• blood diseases.

With hypotension or atony, the neuromuscular apparatus of the uterus is paralyzed, the organ loses its ability to contract, resulting in severe uterine bleeding after childbirth. Pathology is observed with high fetal weight, rapid birth, inflammatory processes myometrium. Most often, this complication occurs in young women, women with congenital anomalies reproductive organs.

Bleeding after childbirth, the causes of which are hypotension and impaired uterine contractility, can occur in different ways. In one case, the blood flows in waves. This is caused by periodic contractions of the uterus, which is accompanied by more abundant blood loss (150–300 ml).

Intense loss of a large volume of blood (up to 1 liter), while the walls of the uterus are completely relaxed.

In case of wave-like bleeding, reducing medications are prescribed and external massage uterus, and also requires manual monitoring of the organ cavity for the presence of placental remains. In case of breakthrough bleeding, many measures are ineffective, so urgent surgery is indicated. Otherwise, anemia, hemorrhagic shock and death may develop.

Why does late bleeding develop?

Postpartum bleeding that begins 2 hours or up to a month after the birth of the baby is called late. After the placenta is delivered, the obstetrician examines it and assesses its integrity. The remainder of the placenta in the uterine cavity may become main reason heavy bleeding. Pathology most often develops within a month. In this case, the woman may have no symptoms of general malaise.

Postpartum hemorrhage, causes:

• inflammatory disease of the uterus.
• remnants of placenta;
• weakening of the body;
• the beginning of menstruation;
• endocrine diseases;
• hormonal imbalance.

Heavy bleeding after childbirth, starting at late period, is a doctor's mistake. Before the patient is discharged, an ultrasound scan of the uterus must be performed; if remnants of the placenta are detected, instrumental curettage is performed.

How is it after childbirth? With menorrhagia, the following symptom complex appears:

• discharge of a bright scarlet color can last more than 7 days;
• body temperature rises;
• the blood clots and has an unpleasant odor;
• Menstruation should not begin if the mother is breastfeeding;
• One pad is not enough for 2 hours.

Menstruation may begin a month after the woman left the maternity hospital if the baby is on artificial feeding. You can recognize the beginning of critical days by characteristic symptoms: It's a dull pain lower abdomen, swelling of the mammary glands, small volume of discharge (up to 150 ml). The duration of menstruation may be a little longer than usual, but... How long the critical days will last depends on the complexity of the birth.

Dysfunctional uterine bleeding reproductive period are caused by a violation of the production of hormones by the ovaries, stress, taking certain medications, lack of vitamins, infectious diseases genitourinary system. Untimely treatment of DUB may lead to infertility.

Methods of prevention and treatment

A woman shouldn't leave maternity room within 2 hours, it is during this period that earlier bleeding may develop. Medical workers monitor the patient's condition and, if necessary, provide emergency assistance. To ensure that the uterus contracts well, the bladder is emptied using a catheter.

After the placenta is delivered, the obstetrician examines its integrity and, if in doubt, performs manual inspection of the uterine cavity for the presence of remains. Checks for ruptures that occurred during childbirth and could cause uterine bleeding. If necessary, the woman is given an external massage of the uterus and cold is applied.

If there are injuries, ruptures, sutures are performed under local anesthesia, this helps stop the bleeding. To increase uterine contractility and prevent hypotension, Oxytocin is administered intravenously.

To stop the bleeding, tamponade is performed. A tampon soaked in ether is inserted into the posterior vaginal fornix, this stimulates the uterus to intensify contractions. If medicinal products if uterine bleeding does not give results, a decision is made on surgical intervention.

If symptoms of pathology appear, it is necessary to urgently call an emergency room. medical care! Late bleeding should be stopped in a hospital setting. In the gynecology department, the uterus is curetted, then antibiotics are prescribed, and drugs that stop the blood are indicated (Vikasol, Dicynon).

In some cases, women require plasma transfusions. Vitamins are taken to maintain the body, and iron supplements are needed for symptoms of anemia. It is important to replenish fluid loss and drink plenty of fluids.

First aid for the development of menorrhagia

If bleeding begins a month after childbirth, when the woman is at home, then the following procedures must be performed before the ambulance arrives:

• take a horizontal position so that your legs are higher than your head;
• apply cold on groin area(ice, frozen foods);
• drink a hemostatic agent.

To preventive measures uterine bleeding refers to feeding the baby on demand. During lactation, the hormone oxytocin is produced. contractile uterus. You can't stand it when your bladder is full. It is recommended to visit the restroom every 3 hours, especially in the first weeks after childbirth.

Can only be taken after consulting a doctor. Herbal medicine recipes include tincture of water pepper, yarrow, shepherd's purse, horsetail, nettle and viburnum bark. , vasoconstrictor, analgesic effect. Stimulate uterine contraction and accelerate tissue healing.

Surgical treatment options

If therapy does not produce results, it is necessary to carry out surgical treatment. Removal of the epithelial layer of the uterus (ablation) is carried out in several ways:

• laser technologies;
• cryodestruction;
• instrumental curettage of the uterine cavity and cervical canal.

In some cases, if after childbirth it is not possible to stop early bleeding, the uterus is removed (hysterectomy). Indications for surgical intervention Endometriosis, fibroids, and uterine prolapse also serve. Removal is performed vaginally or abdominally. Only the uterus is excised or a total hysterectomy with resection of the uterus and vagina is performed.