Postpartum blood stasis

　　1. After the fetus is delivered, the placenta detaches and is expelled from the uterine wall, causing bleeding due to the opening of blood sinuses in the maternal uterine wall. Normally, due to the reduction in uterine cavity volume after delivery and the strengthening of muscle fiber contraction, the blood vessels interwoven between the muscle fibers in the uterine wall are compressed to stop bleeding. At the same time, the blood sinuses close, and bleeding stops. At the same time, due to the hypercoagulable state of the maternal blood, a large number of platelets adhere to the endothelial collagen fibers on the damaged blood vessels after the placenta is stripped, forming thrombi. Fibrin deposits on the platelet thrombi, forming larger blood clots, effectively blocking the uterine blood vessels, so that there is no bleeding when the muscle fibers relax after contraction. If the uterus cannot contract normally due to uterine atony after the fetus is delivered, and the placenta has not yet detached or the blood sinuses have not opened, bleeding will not occur. If the placenta has partially detached or been expelled, uterine atony cannot effectively close the blood sinuses of the uterine wall where the placenta is attached, leading to excessive bleeding, which is the main cause of postpartum hemorrhage. Uterine atony can be caused by excessive tension of the mother, excessive use of sedatives and anesthetics during the delivery process; abnormal fetal presentation or obstructive dystocia, leading to a prolonged labor, exhaustion of the mother; poor development of uterine muscle fibers in the mother; excessive uterine expansion, such as twins, macrosomia, polyhydramnios, causing excessive stretching of uterine muscle fibers; maternal anemia, pregnancy-induced hypertension or gestational uterine fibroids, etc., all of which can affect uterine contraction.

　　2. Rupture of the soft birth canal is another important cause of postpartum hemorrhage. If the uterine contraction is too strong, the progress of labor is too fast, the fetus is too large, it is often possible to cause lacerations of the cervix and (or) vagina before the fetus is delivered. Improper protection of the perineum and improper operation of midwifery can also cause perineal and vaginal lacerations. A small incision in the perineum during fetal delivery is prone to cause severe perineal lacerations, and early perineal lateral incision can also cause excessive bleeding at the incision. Severe perineal and vaginal lacerations can extend upwards to the fornix, para-vaginal space, and even as deep as the pelvic wall. Severe tearing near the deep part of the vagina near the fornix can extend upwards to the broad ligament. During the process of childbirth, slight lacerations of the cervix are almost inevitable, usually shallow and without obvious bleeding, and no diagnosis of cervical laceration is made. Cervical lacerations with more bleeding occur when the fetus passes through the cervix that has not been fully opened too quickly, and in severe cases, it can extend downwards to the fornix of the vagina, and even upwards to the lower segment of the uterus, causing a large amount of bleeding.

　　Common complications include acute and large-volume vaginal bleeding, or persistent small-volume bleeding, and severe cases can lead to shock. At the same time, it may be accompanied by symptoms such as dizziness and fatigue, drowsiness, loss of appetite, diarrhea, edema, milk obstruction, hair loss, aversion to cold, and others.

　　1. Uterine atony:Most of the time, there is uterine weakness during the process of childbirth, which continues until the fetus is delivered, but there are also exceptions. The characteristics of bleeding are delayed placental detachment, with no bleeding or only a little bleeding in the vagina before detachment, and bleeding continuously due to uterine weakness after detachment. The blood that is discharged can coagulate. If the bleeding is not reduced in time, the patient may have symptoms of hemorrhagic shock, such as pale complexion, palpitations, cold sweat, dizziness, weak pulse, and blood pressure drop. When examining the abdomen, it is often felt that the uterine contour is unclear and the fundus cannot be felt, which is due to the uterus being soft and not contracting. Sometimes the placenta has been detached, but the uterus is weak and cannot expel it, and the blood accumulates in the uterine cavity. Massaging and pressing the bottom of the uterus can expel the placenta and the accumulated blood.

　　2. Rupture of the soft birth canal:The characteristics of bleeding are that bleeding occurs after the fetus is delivered, which is different from postpartum hemorrhage caused by uterine weakness. The blood from the soft birth canal can coagulate, and if the injury involves small arteries, the blood is redder.

　　3. Coagulation dysfunction:The manifestation is that the blood does not coagulate and is not easy to stop bleeding.

　　1. The postpartum period is a period of recovery for the reproductive organs. Due to the weakness of the body's vital energy, it is particularly prone to invasion by external pathogenic factors, forming blood stasis syndrome, as the saying goes, 'postpartum is mostly deficiency and blood stasis.' Because blood stasis is mostly caused by cold, attention should be paid to keeping warm after childbirth, avoiding cold winds, and avoiding cold and stimulating foods to prevent the invasion of pathogenic cold.

　　2. Encourage the mother to get out of bed and start moving as soon as possible, and gradually increase the amount of exercise, which is more beneficial for the discharge of lochia and the recovery of the uterus. Those who have the conditions can learn to do postpartum health exercises, strengthen overall exercise, and recover strength as soon as possible.

　　3. Pay attention to postpartum hygiene, change underwear frequently, pay attention to vulvar cleanliness, use sterilized toilet paper, and it is best to use sanitary napkins. Abstain from taking a bath and sexual intercourse to prevent ascending infection.

　　7. Maintain emotional stability, avoid negative mental stimulation such as melancholy and anger, and prevent the aggravation of blood stasis syndrome due to qi stasis and blood stasis.

　　In the diagnosis, in addition to relying on its clinical manifestations, it is also necessary to use auxiliary examinations. The examination of this disease after childbirth includes urine routine, blood routine, stool routine, uterine size, uterine position, and other examinations. This disease seriously affects the daily life of patients, so it should be actively prevented.

　　First, dietary therapy

　　1. Cassia and Hawthorn Brown Sugar Soup:Cassia twig 10 grams, hawthorn fruit 30 grams, add 300 milliliters of water, simmer over low heat to 200 milliliters, add 20 grams of brown sugar, simmer for a moment, and it can be drunk. 1 dose per day, taken 2 to 3 times warm.

　　2. Mugwort, Rice Wine, and Egg Soup:Mugwort 10 grams, wash and cut into pieces, boil with 2 eggs and water, remove the shell of the cooked eggs, put them back into the original juice, add 100 milliliters of rice wine, boil for a while, eat the eggs and drink the soup, once a day.

　　3. Chuanxiong Sugar Tea:Chuanxiong 30 grams, brown sugar 30 grams, add 400 milliliters of water, boil to 300 milliliters, remove the residue and take the juice as tea, 1 dose per day.

　　4. Hawthorn Seed and Lotus Root Soup:Hawthorn seeds 10 grams, lotus root 250 grams. Wash the lotus root and slice it; peel and crush the hawthorn seeds. Put the crushed hawthorn seeds and lotus root in a pot, add 500 milliliters of water, and boil together. Adjust to taste with an appropriate amount of brown sugar or salt. Suitable for postpartum blood stasis fever in women.

　　2. Cinnamon

　　Introduction: The bark of trees such as Cinnamomum sinense and Cinnamomum burmannii in the Lauraceae family. Other names: Sichuan cinnamon, earth cinnamon, laurel.

　　Function: Stimulates appetite, warms the middle and disperses cold. Indications: Cold in the spleen and stomach, decreased appetite, or epigastric and abdominal cold pain, vomiting; external injury blood stasis pain, or postpartum blood stasis abdominal pain in women.

　　3. Crab

　　Introduction: The meat and internal organs of the Chinese mitten crab, a species of crab in the family Grapsidae. Other names: crab, river crab.

　　Function: Continues tendons and bones, promotes blood circulation and removes blood stasis, promotes diuresis and relieves jaundice. Indications: Bruises and injuries, broken tendons and bones, blood stasis and swelling pain; postpartum blood stasis abdominal pain, difficult labor, retained placenta; damp-heat jaundice.

　　1. The postpartum period is a period of recovery for the reproductive organs. Due to the weakness of the body's vital energy, it is particularly prone to invasion by external pathogenic factors, forming blood stasis syndrome, as the saying goes, 'postpartum is mostly deficiency and blood stasis.' Because blood stasis is mostly caused by cold, attention should be paid to keeping warm after childbirth, avoiding cold winds, and avoiding cold and stimulating foods to prevent the invasion of pathogenic cold.

　　2. Encourage the mother to get out of bed and start moving as soon as possible, and gradually increase the amount of exercise, which is more beneficial for the discharge of lochia and the recovery of the uterus. Those who have the conditions can learn to do postpartum health exercises, strengthen overall exercise, and recover strength as soon as possible.

　　3. Pay attention to postpartum hygiene, change underwear frequently, pay attention to vulvar cleanliness, use sterilized toilet paper, and it is best to use sanitary napkins. Abstain from taking a bath and sexual intercourse to prevent ascending infection.