After delivery, the woman should be aware of some symptoms that may indicate the presence of certain complications, such as blood loss through the vagina, foul smelling discharge, fever, cold sweat and weakness, which may indicate a situation called retention placenta.
Postpartum hemorrhage usually occurs soon after the baby leaves the uterus, when the placenta takes off from the uterus, and the placenta does not contract properly, leading to large blood loss. However, this intense bleeding can also begin days or even 4 weeks after the baby’s birth due to the presence of remains of the placenta still in the uterus after normal delivery.
Signs and symptoms of placental debris
Thus, some signs and symptoms that may indicate complications after the baby’s birth are:
Loss of large amount of blood through the vagina, being necessary to change the absorbent every hour;
Loss of sudden blood, in great volume that gets to dirty the clothes;
Palpitation in the chest;
Dizziness, sweating and weakness;
Very strong and persistent headache;
Shortness of breath or difficulty breathing;
Fever and very sensitive abdomen.
With the appearance of any of these symptoms, the woman should go to the hospital quickly, to be evaluated and treated appropriately.
Why it happens and when it can happen
In the vast majority of cases this bleeding occurs within the first 24 hours after delivery, but this can also happen even 12 weeks after the baby’s birth because of factors such as retention of placental remains after normal delivery, uterine infection, or blood clotting such as purpura, hemophilia, or Von Willebrand’s disease, although these causes are rarer.
The rupture of the uterus is also one of the causes of great blood loss in the postpartum and this can happen in women who had cesarean section before a normal birth induced with the use of medicines like oxytocin. However, this is a more common complication during childbirth or early in the first days of postpartum.
Remains of the placenta may remain attached to the uterus even after a cesarean section and sometimes only a very small amount, such as 8mm of placenta, is left for a large bleeding and uterine infection.
How to treat
Treatment of bleeding caused by placental remains should be guided by the obstetrician and may be done using drugs that induce uterine contraction such as Misoprostol and Oxytocin, but the doctor may have to perform a specific massage on the fundus of the uterus and sometimes , blood transfusions may be required.
To remove the remains of the placenta, the doctor may perform ultrasound-guided uterine curettage to cleanse the uterus, completely removing all tissues from the placenta, and indicate to take antibiotics.