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Common causes are trauma; congenital abnormalities; pathologic processes (such as tumors; infections, esp. of the alimentary, respiratory, and genitourinary tracts); and generalized vascular disorders such as purpuras and coagulation defects. Hemorrhage may also result from premature separation of the placenta, particularly with extravasation into the uterine musculature, and from retained products of conception after abortion or delivery. See: abruptio placentae; Couvelaire uterus
An umbrella pack will apply pressure to the uterine arterial supply. When ultrasonography reveals that retained placental fragments are the source of hemorrhage, they are usually removed by suction or surgical curettage. If the uterus is flaccid, it can usually be stimulated to contract by administering intravenous oxytocin. The patient may need transfusion and, in some cases, surgery to prevent fatal hemorrhage.