Final answer:
Delayed postpartum hemorrhage management includes the examination of the expelled placenta to ensure no fragments are left, which can cause bleeding. Uterine contractions and breastfeeding promote involution and reduce PPH risk. If normal mechanisms fail to control bleeding, medical intervention may be required.
Step-by-step explanation:
The management of delayed postpartum hemorrhage (PPH) involves ensuring that no fragments of the placenta remain in the uterus, as they can cause bleeding. An obstetrician must inspect the placenta and fetal membranes after birth for completeness. Contracting uterine muscles not only aid in returning the uterus to its pre-pregnancy size through a process called involution, but also reduce blood loss and facilitate the repositioning of abdominal organs. Additionally, breastfeeding can help with involution and the management of PPH.
Following childbirth, there is a normal discharge called lochia, comprised of various cellular debris, which transitions from lochia rubra to lochia serosa, and eventually to lochia alba over a period of weeks. However, if excessive bleeding occurs and cannot be managed by normal hemostatic mechanisms, medical intervention to restore blood volume and control the hemorrhage may be necessary. In events where the placenta is considered retained, manual or surgical removal may be required to prevent PPH.