Final answer:
To evaluate persistent postpartum bleeding, obstetricians examine the intactness of the expelled placenta and monitor changes in lochia. Uterine contractions and breastfeeding assist in reducing bleeding. Retained placenta fragments and abnormal discharge patterns may indicate a need for further medical interventions.
Step-by-step explanation:
The evaluation of persistent postpartum bleeding after the delivery of the placenta is a critical aspect of postnatal care. It is crucial for the obstetrician to inspect the expelled placenta and fetal membranes to ensure they are intact, as retained placental fragments can cause postpartum hemorrhage. The uterus undergoes uterine contractions and involution post-delivery to return to its pre-pregnancy size and to limit blood loss from the detachment site of the placenta.
Monitoring the postpartum vaginal discharge, called lochia, is also important for evaluating the healing process. Lochia transitions from lochia rubra to lochia serosa, and finally to lochia alba over the course of several weeks. Any deviation from the typical patterns of lochia may require medical attention.
During the afterbirth stage, if the placenta does not birth spontaneously within about 30 minutes, it is classified as retained, which may necessitate manual removal or surgery by the obstetrician. Furthermore, breastfeeding aids in the process of involution and uterine contraction, helping to further reduce postpartum bleeding.