Re: [ozmidwifery] Secondary Postpartum Haemorrhage

[Andrea Quanchi]

yes but sometimes you have just beaten it to the punch and within a day 
or so the infection would make her unwell as it invades her system. The 
bleeding has made her seek attention before the sepsis but the 
treatment still needs to assume there is infection present as this is 
the most common cause otherwise the bleeding will continue
Andrea Q
On 21/04/2005, at 10:42 AM, Dawn Whitten wrote:

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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