bleeding in the postpartum period


  • Peculiarities of the postpartum period
  • Status of women in the immediate postpartum period
  • Bleeding in the early postpartum period
  • Types of bleeding, emerged in the early postpartum period
  • Treatment of bleeding in the early postpartum period
  • Bleeding in the late postpartum period

Do you remember what the sacrament is considered the most sacred on earth? That's right, it is the birth of a new life. All parents with trepidation expecting the birth of their baby. This is especially true with respect to future mothers. And no wonder - because they are directly involved in this sacrament. Moreover - it is basically a woman depends on how the baby will be born healthy.

A woman and, of course, from the doctors. Fortunately, to date, the level of qualification of doctors and modern medicine are quite high, so the child deaths are extremely rare. But, nevertheless, women are very much worried before delivery. And psychologists say that the primary nature of this fear is not nothing but a lack of information. And if the birth rate with the more or less clear - a lot of information, then the postpartum period more difficult. Women do not know what to expect in the early postpartum period.

By the way, sometimes women do not notice and developed complications. Typically, this occurs for two reasons. Firstly, the new-found mommy is so encouraged by the appearance of crumbs to light that weakly perceives the surrounding reality. And secondly, do not notice a problem for a woman can be the banal reason - because she simply does not know how to be normal postpartum period.

This is what will be discussed in this article. We'll tell you about how to proceed should be normal postnatal period, as well as what diseases in this period of time marked by doctors more often. Of course, we will not go into the details of how to eliminate one or another complication - a woman such information does not need it, as it is the immediate task of doctors. However, in general, do you know - such knowledge will help you to avoid the fear of the unknown - in this case, before the manipulation of doctors.

Peculiarities of the postpartum period

So pipsqueak was born. But the woman was still in labor - as long as it will separate and will not leave the last. After that it begins immediately postpartum. And the woman doctors called postpartum women. Himself postpartum period is divided into two stages:

  • Early postpartum

This period is very short - just two hours after the birth of the placenta. This stage is the most critical - it defines all further during the recovery period after birth. Young Mom at this time should be under the strict supervision of doctors, midwives and nurses. About what is happening in this period in a woman's body, we will tell you a little later.

  • Late postpartum

It begins two hours after delivery of the placenta and lasts 40 days. As a rule, women relax and believe that their health is not in danger. However, it is not - as long as the uterus does not shrink to its original size, there is always a certain risk of various complications. In particular - postpartum endometritis.

Status of women in the immediate postpartum period

So let's talk about what happens to a woman's body in the early postpartum period. The walls of the uterus begins to decline very active, resulting in just a couple of hours at times uterus shrinks. Its walls begin to thicken, and the very body of the uterus becomes spherical. Just a couple of hours back and front wall of the uterus is already tightly pressed against each other.

The cervix also has a very distinctive appearance - it looks like the bag, wrinkled and with very thin walls. The doctor can easily enter into the uterus of the hand - and the woman does not feel the stretching of the cervix much discomfort. Uterine weight immediately after childbirth is about 1000 grams.

During labor, the fixing unit as ligament, very stretched. And because of this, the uterus is very mobile and easy shifting. By the way, this phenomenon is largely due to the state and the pelvic floor muscles. That is why it is important to promptly empty the bladder. Otherwise full bladder will lead to a permanent displacement of the uterus. And hence, a deterioration of its ability to contract. A similar phenomenon is fraught with the development of a wide variety of complications.

Among've never given birth women are of the opinion that immediately after birth mom immediately falls asleep. However, this is not so. Of course, a woman much tired as her body did very hard work. However, the nature smarter than us - the woman produced a huge amount of restorative materials. And the emotional impact makes itself felt. So the first few hours after birth for women is clearly not sleep.

But this is only the case if a woman is healthy. In the same case, if a woman appeared drowsy, or, worse, to drowsiness now and vomiting, the doctor has a reason to suspect the presence of cerebral hypoxia. And this pathology, in turn, indicates the most extensive hemorrhage. And frequently it is internal, so the external signs of it is almost impossible to guess.

The changes do not bypass the party and the functioning of the cardiovascular system. This is not surprising - is the baby to be born as a woman's body takes a number of changes:

  • Eliminating Uteroplacental additional circulation.
  • Reducing intra-abdominal pressure.
  • Drastic hormonal changes in the body of a young mother.

All this leads to the fact that women almost immediately after delivery greatly slows the pulse and blood pressure changes. Moreover, in most cases, it is largely reduced. Although there are exceptions - cases in which the blood pressure, in contrast, increased. As a rule, this is typical of those women who, and before pregnancy, and during regularly faced with hypertension. Similarly, women need to very carefully monitor their condition.

Body temperature in most cases remains normal. But sometimes it can be for a short time to raise up to 37, 5 - 38 degrees. This is a consequence of hyperthermia stress - both physical and emotional. Typically, doctors are not particularly worried about such a rise in temperature. Of course, if they do not last more than an hour - otherwise you need to sound the alarm as often prolonged increase in temperature indicates the development of an inflammatory process.

 early postpartum period

Bleeding in the early postpartum period

One of the most serious complications in the immediate postpartum period is bleeding. In that case, if it originated in the first two hours after birth, it is called - early postpartum hemorrhage. There are several reasons that lead to the development of bleeding:

  • Hypotension and uterine atony

Doctors call this term is a condition in which there is a strong decrease in the normal tone of the uterus. As a result, the walls of the uterus are reduced much worse than expected, and the anxiety also greatly reduced. Complete loss of these abilities does not occur - the uterus still continues to respond to the administration of medications, mechanical and physical stimuli. Although the force with which the queen must respond to these stimuli, hypotension is much weaker than in other cases. Moreover, some women doctors say a kind of paradox - the stronger the stimulus, the weaker the response of the uterus.

In the most severe cases can also be a critical degree of hypotension uterus - atony. When atony comes complete loss of tone of the uterus, the ability to contract. Moreover, in this case the response of the uterus does not cause even the strongest stimulus and medicines. Simply put, the uterus is in a state of so-called paralysis. Fortunately, this phenomenon is very rare. But that it can cause death.

In that case, if the reason for the bleeding originated in the early postpartum period, it has become hypotension uterus, it is rarely too intense and stable. Of course, if it is not about atony - with her bleeding is very abundant and intense, it is extremely difficult to stop. If hypotension as blood is released slowly, in small portions. As a rule, most often in the blood contains blood clots. This is especially observed in incomplete separation of the placenta. In addition, the cause of hypotension uterus may become too strong it hyperextension. For example, if the twins were born, or if the baby was born very close.

Additionally, this abnormality can result from prolonged deliveries lasting more than 24 hours. Although in fairness it should be noted that doctors are well aware of this feature and pre-take all necessary measures to prevent bleeding. In addition, the cause of hypotension uterus can become a long-term and systematic use of drugs that reduce the tone of the uterus. Typically, these drugs are prescribed to save the pregnancy as a uterine tonic.

No less dangerous and premature detachment of the placenta. Not only that, it can lead to hypoxia and even death of the baby, it also provokes the development of hypotension, and sometimes uterine atony. And as a result, bleeding, developed in the postpartum period. Yes, and so the risk of encounter

Moreover, this type of bleeding is very peculiar - a very significant part of the blood accumulates in the cavity of the uterus and the vagina. That is why in some cases such bleeding is detected immediately. But do not worry too much about it - gynecologist examining a woman is often in the early postpartum period. And he definitely notice the inevitable increase in the size of the uterus, which is due to the accumulation of blood in it. And sooner or later, the blood starts to stand out.

Typically, due to the fact that the contraction of the uterus is rather weak, it is unable to escape from the cavity are in blood clots. However, very often the doctors quickly eliminate them by a simple, but very cautious pressure on the very body of the uterus. After that special woman intravenously administered medication. In some cases, you may need a manual examination of the uterus - while the doctor inserts his hand into the uterus and manually removes the remnants of the placenta and the blood clots. Afraid this is not necessary - it goes without saying that this manipulation is carried out only under general anesthesia. In most cases, these measures are sufficient to resolve the problem.

  • A bleeding disorder

In some cases, the cause of postpartum hemorrhage is not nothing but a systemic disease, which resulted in worsening blood clotting. Although these days, as a rule, this happens very rarely. For women during pregnancy undergo rigorous examination. And all the diseases identified in advance. This means that doctors already know exactly what to expect and are prepared in advance. Therefore, it is important to promptly see a doctor during pregnancy.

  • Rupture of the uterus and its neck

Sometimes, severe bleeding occurs if during childbirth ruptured uterus body. Or in case of severe lesions of the cervix. Such cases are diagnosed by doctors in the first minutes after birth, to take emergency measures to address the damage. As a general rule, a fairly simple repair for ruptures. But in some cases to save the life of a woman may need a hysterectomy. The risk group women wearing twins too large baby. And, of course, those moms who already have a child, born by Caesarean section. Especially if the interval between delivery of at least three years.

Types of bleeding, emerged in the early postpartum period

Of course, any bleeding is a pathology. However, the bleeding bleeding strife. Doctors are two main types:

  • Profuse bleeding

In this case, the bleeding is very strong, massive. It begins, as a rule, a sudden and very large loss of blood. The body of the uterus is very flabby, lose the ability to contract properly. The uterus does not respond properly to stimuli - hand massage, outdoor, the introduction of various medications designed to reduce the uterine wall. Very fast developing hemorrhagic shock - a condition that represents a serious danger to a woman's life.

  • Wavy bleeding

This bleeding is radically different from the previous type. In this situation, the relaxation of the uterus is not constant, but periodically. Therefore, the blood flows in equal portions of about 200 ml. In this case, the uterus is adequately responding to external stimuli and the introduction of medicines - begins to shrink. This condition is less dangerous to life and health of the woman. And doctors cope with it much faster.

But this is only the case if the problem is noticed in a timely manner. Otherwise, the compensatory capacity of the organism newly-mom sooner or later exhausted: bleeding heavily amplified, hemorrhagic syndrome develops. Fortunately, when a woman gives birth in a maternity hospital, this can not happen because the doctors are very carefully watching her.

Treatment of bleeding in the early postpartum period

We sincerely wish you to all the information that you have just learned, will never come in handy in practice. But, unfortunately, sometimes like that does occur. And if the woman knows what she expected, it will be more relaxed. So, how to solve bleeding in the early postpartum period are divided into:

  • Mechanical

In this case, doctors stimulate the uterus by direct action on it. That impact, as a rule, is a massage of the uterus - both external and direct.

  • Medication

There are a number of pharmacological agents that are the most effective way to stimulate uterine contractions. If necessary, the doctor will select the most appropriate for each case preparation.

  • Operational

In the event that other methods are ineffective, doctors are forced to resort to surgical methods. These include manual examination of the uterus, two-handed massage, in severe cases - removal of the uterus.

Generally, treatment is often complex. The first thing doctors do - is using a catheter to empty the bladder. Then, through the abdominal wall, begin External massage of the uterus. At the same time, these women intravenously administered drugs - mostly oxytocin. If necessary, if the bleeding is too strong, or if a woman is emaciated, may be appointed as an intravenous infusion of glucose solution, which will provide much needed support for the woman.

In the event that this measure would be ineffective in the "game" come anesthesiologist. Mom introduced intravenous anesthesia, after which a gynecologist gets a hand into the uterus and begins its investigation. The physician must make sure that the uterus remained pieces of placenta and that the integrity of the uterus and the cervix is ​​not compromised. At the same time it held a very powerful uterine massage. These manipulations are most effective in the early stages of bleeding.

In addition, a very effective introduction to the cervix prostaglandins - stop even very heavy bleeding. Of course, all these manipulations should be accompanied by supportive care - blood volume should not apply below the critical level. Therefore, if necessary, the woman can be assigned to saline infusion, and sometimes a blood transfusion.

In severe cases when all other measures are useless, perhaps, the doctors do tubal vessels. If these measures prove ineffective, doctors may decide to remove the uterus. In medicine, this operation is called a hysterectomy. Of course, this measure doctors have resorted to the most extreme case, when a woman's life is in real danger, and other ways to help her do not exist.

 bleeding in the postpartum period

Bleeding in the late postpartum period