Patient's question:
I am breastfeeding, and my child is two months old. I often experience bleeding, but the amount is very small, not exceeding 5 drops per day, occurring every few days. It doesn't hurt, and I have less urine. An ultrasound showed no abnormalities. Could you please tell me what this condition might be?Additional information: I had a cesarean section due to placental abruption and severe bleeding. I received 400 ml of blood transfusion post-surgery.
Doctor's answer:
Hello:After a normal delivery, that is, after the baby and placenta have both left the mother's body, the uterus will contract, and the amount of bleeding will also decrease to the level of a normal menstrual period. However, bleeding exceeding 500 milliliters after childbirth is not normal bleeding but rather postpartum hemorrhage. The normal amount of bleeding for vaginal delivery is 350–500 milliliters; for cesarean delivery, the maximum blood loss can reach 750–1,000 milliliters. Postpartum hemorrhage accounts for approximately 3–5% of all deliveries, and it most often occurs within the first 24 hours after childbirth.
There are many causes of postpartum hemorrhage, but 75–80% of cases are due to uterine atony. Uterine atony refers to the lack of uterine contractions. Multiple births, twins, polyhydramnios (excessive amniotic fluid), a very large fetus, prolonged or abnormally short labor, and other factors can all cause excessive fatigue in the uterus, leading to postpartum hemorrhage.
The best way to promote uterine contractions is for the mother to breastfeed. The baby's suckling stimulates uterine contractions, which can compress blood vessels and reduce bleeding.
If breastfeeding does not stop the bleeding, the following emergency measures should be taken:
① Intravenous infusion of oxytocin to stimulate uterine contractions.
② Uterine massage (massaging the lower abdomen) to empty the bladder.
If these steps do not improve the situation, the doctor may perform the following examinations on the mother:
① Vaginal examination. Sometimes blood clots in the lower uterus or cervix can obstruct uterine contractions. Removing these clots can help the uterus contract.
② Checking hemoglobin and hematocrit levels. If hemoglobin is too low or bleeding persists,