We had a lady who had 3 or 4 PPHs.  Finally required an embolisation of a
vessel around? In? her uterus.
Aside from severe tiredness (related to blood loss) she appeared well in
between PPHs.  I am not sure how unusual this is.
Lindsay
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Dawn Whitten
Sent: Thursday, 21 April 2005 10:43 AM
To: [email protected]
Subject: Re: [ozmidwifery] Secondary Postpartum Haemorrhage


Thanks that is a great help Andrea

Is it atipical to have no fever, and generally feel 'well' when infection
is the cause of 2ndy postpartum haemorrhage?

Thanks again

Dawn

At 08:47 AM 21/04/05 +1000, you wrote:
>Dawn,
>
>I would think that haemorrhage at this stage would nearly always be due 
>to infection and thus would require antibiotics as the lining of the 
>uterus is eroded by the infection to such a degree that bleeding is 
>occurring and until the infection is gone tissue regeneration will not 
>occur.
>
>You would also need to eliminated other causes of bleeding at this 
>stage and the two that come to mind would be
>       resumption of sexual activity causing trauma
>       resumption of mensus
>
>Hope this helps
>
>Andrea Q
>On 20/04/2005, at 8:34 PM, Dawn Whitten wrote:
>
>> Hi All,
>>
>> Would love to hear opinions on appropriate treatment of secondary 
>> postparum
>> haemorrhage at around 28 days postpartum.
>>
>> Is routine prescribing of antibiotics appropriate?
>>
>> Are there different ideas around when curettage is appropriate? Is this
>> procedure over used?  Does ultrasound predict retained placenta 
>> accurately?
>>
>> Many Thanks
>>
>> Dawn
>>
>>
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