occult postpartum hemorrhage
Introduction
Introduction Postpartum hemorrhage is called vaginal bleeding within 24 hours after delivery of the fetus.
Cause
Cause
The cause of late postpartum hemorrhage:
Weak uterus, soft birth canal laceration and so on.
Examine
an examination
Related inspection
Obstetric B ultrasound gynecological examination
Examination and diagnosis of recessive postpartum hemorrhage:
The amount of bleeding can be measured to diagnose.
Diagnosis
Differential diagnosis
Recessive postpartum hemorrhage should be identified as follows:
1. uterine weakness: should be alert, sometimes the placenta has been discharged, the uterus is slack, a large amount of blood accumulates in the uterine cavity, and vaginal bleeding is only a small amount, the maternal symptoms of excessive blood loss, so in addition to pay close attention to vaginal bleeding after delivery, also Should pay attention to the uterine contraction.
The visual measurement of vaginal bleeding is much less than the actual amount of blood loss, so the measurement must be collected with a curved disc. There is uterine atony before the delivery, the placenta delivery process and excessive bleeding after delivery, the diagnosis is no difficulty, but be alert to the aforementioned hidden postpartum hemorrhage and may be associated with birth canal laceration or placental factors.
2. Soft birth canal laceration: Cervical laceration is mostly on both sides, and may also be petal-like. If the laceration is heavier and spreads to the cervix, a large amount of bleeding will occur. Cervical laceration can be broken to the lower part of the uterus.
Vaginal laceration is mostly in the vaginal wall, posterior wall and perineum, and is often irregular laceration. If the vaginal laceration affects deep tissue, it can cause severe bleeding due to blood supply. At this time, the contractions are good. A vaginal examination can identify the location of the laceration and the severity of the laceration.
The degree of perineal laceration can be divided into 3 degrees. I degree refers to the perineal skin and vaginal entrance mucosal tear, not reaching the muscular layer, generally not much bleeding. II degree means that the laceration has reached the muscular layer of the perineal body, involving the mucosa of the posterior wall of the vagina, and even the groove on both sides of the posterior wall of the vagina is torn upwards. The laceration may be irregular, making the original anatomical tissue difficult to identify and bleeding more. The third degree anal external sphincter has been broken, and even the vaginal rectum and part of the rectal anterior wall have laceration, which is serious. But the amount of bleeding is not necessarily a lot.
