Causes of Postpartum Bleeding and its Handling

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Causes of Postpartum Bleeding and its Handling
Causes of Postpartum Bleeding and its Handling

Postpartum hemorrhage or bleeding after giving birth is still the main cause of death for pregnant women, especially in developing countries. This condition can be caused by various causes, so the treatment can be different

Bleeding after childbirth is a common condition. However, under certain conditions, the bleeding can be abnormal or excessive. This abnormal condition is also known as postpartum hemorrhage. This bleeding can occur during vaginal delivery or caesarean section.

Causes of Postpartum Bleeding and Treatment - Alodokter

Postpartum haemorrhage occurs when a mother who has just given birth loses more than 500 ml of blood within 24 hours or within the first 6 weeks after the baby is born. This condition requires proper treatment because it can threaten the life of the mother.

Various Causes of Postpartum Bleeding

After the baby is born, the uterus will usually contract to release the placenta or placenta which is attached to the uterine wall. After the placenta is successfully expelled, contractions are still needed to compress the blood vessels in the uterine wall where the placenta attaches and stop bleeding.

If the uterine contractions are not strong enough, the blood vessels will continue to open so that postpartum hemorrhage can occur. Other conditions that can also cause postpartum hemorrhage, namely:

  • Tears after childbirth in the vagina or the area between the vagina and anus, for example due to a baby being too large
  • Uterine atony, which is a condition where the uterine muscle tone is lost so it can't contract and compress the blood vessels
  • Retention of the placenta, which is a condition when part or all of the placental tissue does not come out after giving birth
  • Disorders in the blood clotting process, for example due to a deficiency of the enzyme thrombin
  • Tear tear or uterine rupture

Meanwhile, there are several factors that can increase the risk of postpartum hemorrhage, namely gestational age less than 18 years, history of caesarean section, previous postpartum hemorrhage, placental abruption, anemia during pregnancy, and placenta previa.

How to Overcome Postpartum Bleeding and its Prevention

Postpartum haemorrhage or postpartum haemorrhage requires prompt treatment. Therefore, for 24 hours after delivery, obstetricians and midwives will conduct regular checks or monitoring.

If postpartum hemorrhage is unavoidable, obstetricians or medical personnel will take several measures to stop postpartum hemorrhage, such as:

1. uterine massage

If bleeding occurs because the uterine muscles cannot contract, the doctor or midwife will massage the uterus to stimulate contractions so that the bleeding can stop immediately. This method can be done only by massaging the abdomen or accompanied by pressing the uterus directly through the vagina.

2. Administration of oxytocin

In addition to massage, the doctor or midwife will also give the hormone oxytocin. The trick is to inject the hormone oxytocin through an IV to stimulate contractions and stop bleeding.

3. Foley catheter insertion

The use of a Foley catheter can also be an option. This tool is in the form of a small rubber tube whose tip can expand like a balloon, so it can be used to put pressure on the open blood vessels in the uterus.

4. Manual expulsion of the placenta

A placenta that only partially comes out or does not come out at all needs to be removed manually immediately, by tracing the uterus with your fingers. In some cases, this procedure can pose a risk of complications. Therefore, its implementation must be carried out by a doctor or midwife.

5. Curettage

If postpartum bleeding continues, the placenta will be removed by curettage. The principle is similar to manual removal of the placenta, but curettage uses a special sterile instrument.

6. Operation action

In more severe cases, open surgery or laparotomy will be performed to find and treat the cause of postpartum hemorrhage. If all efforts have been made but have not been able to control the bleeding, hysterectomy will be the last resort to save lives.

After the bleeding stops, you will feel very weak and at risk of developing anemia. Therefore, the doctor will advise to rest and consume fluids and nutritious foods to increase blood, such as red meat and green vegetables.

In addition, the doctor will also prescribe folic acid and iron supplements. If needed, blood transfusions can be given to replace the blood that is a lot out of the body.

As previously mentioned, postpartum hemorrhage can occur immediately after giving birth, even a few weeks after. Therefore, if the bleeding after giving birth is increasing, for example, the pads are always full every 1-2 hours, immediately consult a doctor.

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