secondary postpartum haemorrhage
Last reviewed 01/2021
Secondary post-partum haemorrhage is the presence of any excess, frank bleeding 24 hours after delivery. It most usually occurs 8 to 10 days after this time. It occurs after approximately 1% of all deliveries.
- retained products of conception
- displacement of blood clot
- abnormal involution of the placental site
An offensive discharge pv implies an infectious aetiology. This is managed by 'blind' systemic, broad-spectrum antibiotics while waiting for culture results from a high vaginal swab.
Conservative management may be appropriate if the vaginal loss is slight and there is no sign of infection.
If there is heavy vaginal bleeding, a tender uterus with an open os, or the suggestion of retained products on ultrasound examination then this requires obstetric exploration.