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Postpartum hemorrhage corresponds to excessive blood loss after delivery due to the lack of contraction of the uterus after the baby has left. Hemorrhage is considered when the woman loses more than 500 mL of blood after normal delivery or more than 1000 mL after cesarean section. Postpartum hemorrhage is the main complication during and after delivery, which can lead to shock and, consequently, death. Find out what are the main causes of death in childbirth.
This type of bleeding occurs more frequently in women who have attempted a normal delivery for several hours but have ended up having a cesarean section. However, it can also happen in women who have a scheduled Caesarean section and who have not yet gone into labor.
Causes of postpartum hemorrhage
Postpartum bleeding, known as locus, lasts for a few weeks and is characterized by the outflow of blood quantities similar to menstruation, being considered normal. However, when there is a loss of excessive amounts of blood, it is a sign of hemorrhage, the cause of which must be identified and treatment must be started immediately afterwards. Some of the possible causes of postpartum hemorrhage are:
- Prolonged labor for more than 12 hours;
- Uterine atony, which is the loss of the ability of the uterus to contract after placental exit;
- Great distention of the uterus during pregnancy of twins or more babies;
- Presence of fibroids in the uterus, which makes it difficult to contract the uterus during labor;
- Use of medications, such as muscle relaxants, or large amounts of magnesium during pregnancy;
- Wound in the uterus caused by spontaneous delivery;
- Changes in the blood clotting process, where bleeding is more difficult to stop;
When one or more factors are present, the risk of bleeding after delivery is even greater.
Although it is more common during childbirth, this hemorrhage can also occur until the first month after delivery, if there are traces of the placenta still glued to the uterus, however, the latter does not put the mother's life at risk of death. See when to worry about postpartum bleeding.
Warning signs
The main warning sign is the loss of more than 500 mL of blood, which can be perceived through some signs and symptoms such as fainting, pallor, weakness, difficulty standing or holding the baby, besides there may be in some cases fever and abdominal pain.
Although it is not possible to predict that there will be a hemorrhage during childbirth, it can be prevented by taking some measures, such as treating anemia during pregnancy, preparing for normal childbirth through preparation classes for childbirth and practice of exercises during pregnancy to gain more resistance and for a normal delivery to be faster.
In addition, it is important to only take the medications indicated by the doctor, in the dosage and for the time recommended by the obstetrician, also reading the package insert and watching for signs that something is not right before and during labor.
How the treatment is done
The control of bleeding after delivery is done by doctors through direct massage in the uterus and administration of oxytocin directly into the vein, as this hormone promotes contraction of the uterus. In more severe cases, the doctor may choose to cut the arteries that irrigate the uterus or even for its removal, to control the bleeding and save the woman's life.
In addition, the doctor may recommend blood transfusions to replace the amount of iron and hemoglobin in the body and restore the supply of oxygen to the organs. After an episode of postpartum hemorrhage, it is normal for the woman to have anemia for a few more weeks, needing to take an iron supplement for a few months.
How is recovery
Due to the great blood loss, the woman may have anemia for a few weeks, being necessary to carry out the treatment indicated by the doctor, which usually includes increased iron consumption. Among the symptoms of anemia are tiredness and excessive sleepiness, which can hinder the first care of the baby at home. Know the best foods for anemia.
Despite this, breastfeeding should not be harmed and all the mother's strengths must be in order to feed herself and ensure her safety and that of her baby. In addition, having someone at home to help with cooking, cleaning the house and washing clothes can be essential to keep calm and keep everything under control.