What to do if you have postpartum bleeding in late pregnancy

  Postpartum hemorrhage in late pregnancy refers to massive uterine bleeding that occurs during the puerperium 24 hours after the end of labor. The onset is most common 1-2 weeks after delivery, but it can also occur as late as 2 months after delivery. It requires prompt medical attention or timely symptomatic treatment in the hospital.  The most common cause of postpartum bleeding in late pregnancy is residual placenta and membranes. The residual tissues become deformed and necrotic, forming polyps, which cause bleeding when the necrotic tissues fall off. It can also be seen in meconium residue, infection of the placental attachment surface of the uterus, and uterine wound dehiscence after cesarean section. The primary treatment is to stop the bleeding and administer antibacterial agents and contraction agents. If it is suspected to be due to placenta, fetal membrane, meconium residue or incomplete replication of placental attachment site, timely curettage should be performed. The scrapings are sent for pathological examination to clarify the diagnosis. For suspected cases of uterine incision dehiscence after caesarean section, if the amount of bleeding is small, close observation can be performed; if the amount of bleeding is large, percutaneous femoral artery cannulation for uterine artery embolization and internal iliac artery embolization can be performed. Other causes can be treated symptomatically. For this type of women, medical care should also be done to closely observe vaginal bleeding and maternal vital signs.  Once this type of disease occurs, both the health care provider and the mother are to remain calm, actively search for the cause of the bleeding, and provide timely symptomatic treatment.