Hypotonic bleeding: early postpartum period after childbirth

Hypotonic bleeding - a pathological condition caused by a decrease in muscle tone of the uterus wall. Accompanied by the appearance of heavy bleeding from the genital tract. It occurs during or after the placenta itself. Bleeding can be caused by incomplete breeding ovum at spontaneous abortion.

why is there

The main causes of a hypotonic bleeding in the early postpartum period are:

• uterine hypotension (accompanied by the appearance of rare and weak muscle contraction);
• atony (characterized by a pronounced decrease in tone, up to its complete disappearance).

The above condition develops due to the following factors:

• fetoplacental deficiency of hormones that stimulate uterine contractions in all the stages of labor;
• violations in areas of the genetic code responsible for the contractile function of muscle fibers of the uterus during childbirth and the allocation required for this energy;
• morphological changes in the tissues of the uterus (the insufficient development of institutions responsible for the generic activities, the presence of scar and inflammatory changes of the nerve endings of the myometrium, uterine distension walls);
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• complications during childbirth (weak labor activity, late toxicosis, inflammation of the mucous membranes of the uterus and ovaries, surgical obstetrics);
• hemodynamic instability (poor blood clotting, varicose pelvic veins);
• the birth of a large fetus.

What are the symptoms

Signs of postpartum hemorrhage include:

• Continuous or periodic occurrence of bleeding, vaginal discharge. Hypotonic bleeding are lightning-fast. In this case, immediately after the placenta, a large amount of blood, the uterus does not contract, develop hemorrhagic shock. At moderate blood loss appear at the first allocation of uterine contractions. Hypotension body alternates with toning, face blood clots.
• Deterioration of general condition. The patient complains of dizziness, intense thirst, nausea. Skin blanch, blood pressure is falling, heart rate increases.
• Signs of hemorrhagic shock. Condition accompanied by severe muscle weakness, transient loss of consciousness, seizures vomiting. If massive blood loss the patient goes into a coma. Pulse rate, shortness of breath, skin become cyanotic hue. Urination is terminated, blood pressure is lowered to the critical parameters. Severe blood loss leads to the development of renal and heart failure. Growing swelling of the lower extremities.
• DIC. Pathological state develops on the background of the prolonged moderate bleeding. clotting system stops functioning. The platelet count decreases sharply increases during contraction of a blood clot. DIC is accompanied by strong uterine bleeding, which can not be cut short, rapid heart rate, fainting, and pulmonary embolism. The cause of death becomes a cardiac arrest.

Treatment and prevention

pathological condition, the treatment is aimed at restoring the uterine motility. For this purpose:

• Scraping. Part of the gestational sac is removed with a curette.
• Manual placental abruption. It contributes to the normalization rate and cessation of bleeding. The procedure reduces the level of progesterone blocking contractile activity. It does not remove the hand from the uterus to restore motor body.
• Drug therapy. Subcutaneously or intramuscularly injected Pituitrin or Oxytocin. It is necessary to carefully select the doses of drugs otherwise hypotension increases.
• Imposition of warmer ice. Strengthens uterine contractions, stopping the bleeding.
• Application of a transverse weld on the cervix. To do this, use the thick catgut thread. Stitches are removed after 12-24 hours.
• Klemmirovanie. Using special forceps clamped side of the uterus departments. One part of the clip gets into the body cavity, and the other - the wall. Large vessels are pressed, the bleeding stops. Clamps can be superimposed on the exterior portion of the uterine wall over the side sections of the vagina. On clips worn rubber tube that prevents damage to the mucous membranes of the cervix and pelvic organs.
• Hysterectomy. Hysterectomy is performed at the inefficiency of other methods and the development of life-threatening bleeding.

Prevention hypotonic bleeding after childbirth involves early detection and elimination of inflammatory diseases, monitoring of blood clotting during pregnancy, carrying out activities aimed at preventing violations of generic activity. During labor, oxytocin infusion administered. To restore the contractile activity of muscle tissue is introduced 40% glucose, 1% Sygethin solution and 10% calcium gluconate.