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What causes heavy post natal vaginal bleeding?

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Posted on Wed, 9 Jul 2014
Question: Im about 2 weeks post natal and the bleeding i think has become heavy in the last few days.... I have noticed a few dark maroon/ black colour bloges. Is this normal?
doctor
Answered by Dr. Shanti Vennam (15 minutes later)
Brief Answer:
It is not normal.

Detailed Answer:
Hello,

Thanks for posting your query.

As you enter the third week of postpartum, the involution of the uterus is in progress and as such, the bleeding surface shrinks thereby reducing the bleeding.

The fact that you have persistent and in fact, increased bleeding calls for immediate medical attention. Either you have some amount of retained products that may have hampered the uterine involution, or infection, leading to this persistent bleeding. The discharge noticed could be due to retained bits or clots.

In the current scenario, you need a complete evaluation by an expert that includes an examination, pelvic/trans-vaginal sonogram, blood profiles and urinalysis.

Treatment should be planned according to the cause; any infection should be treated, any retained products should be removed under antibiotic cover, any hormonal imbalances supplemented and general nutrition improved. Coagulation profile also should be well-monitored and managed appropriately.

Hope your query has been answered. Please feel free to contact for further clarifications. I will be happy to help.

regards,
Shanti.V.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shanti Vennam (15 minutes later)
So
I should check this? I was getting abdominal pain too. Could it be due to not taking enough rest or expressing milk?
doctor
Answered by Dr. Shanti Vennam (12 minutes later)
Brief Answer:
Yes, you should.

Detailed Answer:
Hi,

Thanks for writing back.

Of course, you should check why you are bleeding for so long. Abdominal pain in mild nature can be felt as uterine after contractions as the involution progresses; pain may not be related to the delivery also.

Milk expression does not cause abdominal pain. Prolonged sitting and odd postures can cause it. Please try using some abdominal support and rest in reclining position. Abdominal exercises, properly guided, help to tone up the lax muscles.

Hope I have clarified your doubt. Please get back if you need more information. I will be ready to help.

regards,
Shanti.V.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shanti Vennam (6 hours later)
They did a urine which showed traces of blood and lucocites. Could it be infection?
doctor
Answered by Dr. Shanti Vennam (8 hours later)
Brief Answer:
Infection is a possibility.

Detailed Answer:
Hi,

Thanks for writing again.

A few pus cells are a common finding and do not necessarily indicate an infection, but, in more number, yes. Presence of blood in uncontaminated urine is usually seen when there is some infection. In such cases, I order for urine culture tests. Discuss with your doctor. Further treatment can be planned accordingly.

Hope your query has been clarified. Please contact if you need any more information. I will be ready to help.

Regards,
Shanti.V.

Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Shanti Vennam (35 hours later)
Hi they did
A
Scan today but could
Not see properly as bladder was not
Full but the sonographer said it seems like there are some retained products.what does this mean?
doctor
Answered by Dr. Shanti Vennam (1 hour later)
Brief Answer:
Remnants of placental bits and membranes.

Detailed Answer:
Hi,

Thanks for writing back.

Retained products means that there are some pieces of placenta or membranes left behind in the uterus. If it is not possible through abdominal sonogram to get a clear picture, a trans-vaginal sonogram will show everything clearly.

If retained products are diagnosed in a repeat sonogram, they should be cleared under antibiotic coverage as otherwise, infection and prolonged bleeding can occur.

Hope I have clarified your query. Please contact if you need any more information. I will be available to help.

regards,
Shanti.V.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shanti Vennam (53 minutes later)
Will i need an operation?
doctor
Answered by Dr. Shanti Vennam (10 hours later)
Brief Answer:
Detailed below.

Detailed Answer:
Hello,

Thanks for writing back.

Firstly, the presence of retained products as the cause of the bleeding should be confirmed through clinical findings and a trans-vaginal sonogram. If it is so, simple dilatation and evacuation under local or short general anesthesia and under antibiotic cover will help solve the problem.

Please do not worry, this is a simple procedure and you will not need any operation.

Hope your doubt has been clarified. Please contact if you need any more information. I will be available to help.

Wish you good health.

regards,
Shanti.V.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Shanti Vennam

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What causes heavy post natal vaginal bleeding?

Brief Answer: It is not normal. Detailed Answer: Hello, Thanks for posting your query. As you enter the third week of postpartum, the involution of the uterus is in progress and as such, the bleeding surface shrinks thereby reducing the bleeding. The fact that you have persistent and in fact, increased bleeding calls for immediate medical attention. Either you have some amount of retained products that may have hampered the uterine involution, or infection, leading to this persistent bleeding. The discharge noticed could be due to retained bits or clots. In the current scenario, you need a complete evaluation by an expert that includes an examination, pelvic/trans-vaginal sonogram, blood profiles and urinalysis. Treatment should be planned according to the cause; any infection should be treated, any retained products should be removed under antibiotic cover, any hormonal imbalances supplemented and general nutrition improved. Coagulation profile also should be well-monitored and managed appropriately. Hope your query has been answered. Please feel free to contact for further clarifications. I will be happy to help. regards, Shanti.V.