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Bleeding in the second half of pregnancy and childbirth


In the vast majority of cases, they are explained by anomalies of attachment, separation and birth of a child's place. For example, with his presentation or premature detachment from the walls of the uterus. Relatively rare bleeding may be due to other causes, which include: 1) varicose nodules in the vagina and the external genitalia; 2) polyps, erosion and cancerous ulcers on the cervix; 3) traumatic damage to the genital organs; 4) ruptures of the umbilical vessels of the fetus during the membrane attachment of these fetuses, etc.
Symptoms and course:
The clinical course of pregnancy and childbirth with the presentation of a child's place is very characteristic. The placenta, which almost does not have the ability to contract during the stretching of the lower segment of the uterus and its contractions, lags behind its mother surface from the placental area. As a result, the connection between the uterus and the placenta is broken, the sinuses of the intervillous spaces are opened and bleeding begins. Especially intensive is the detachment of the placenta from its bed at the beginning of labor, during each fight: bleeding does not stop until the uterus cavity is emptied of the fetal egg, i.e. Until the end of labor.
At rupture of soft tissues of patrimonial ways bleeding from genital ways does not decrease and after introduction of the preparations reducing a uterus.
Treatment:
When bleeding occurs during pregnancy, the patient is immediately placed in the maternity ward to find out his cause. In the third stage of labor, in the first place, it is necessary to exclude ruptures of the cervix and soft tissues of the birth canal, having examined them with the help of wide vaginal mirrors. After that, establish whether the latter has separated, if so, the uterus acquires the appearance of an hourglass, the ligature superimposed on the umbilical cord at the sexual slit of the parturient woman, drops 8-10 cm and more, and so on. If the latter is only partially separated, then the measures are carried out in the following sequence: 1) empty the bladder with a catheter, 2) inject drugs that cut the uterus (1 ml of a 1% solution of methylergometrine or 1 ml of oxytocin), 3) squeeze out the uterus Krede Lazarevich without anesthesia or under it, 4) manual separation of the afterbirth. With severe bleeding, you should immediately start the "manual" method, without losing time on less effective ones.