Post-Cesarean Complications: Excessive Bleeding Two Months Later

Heavy bleeding more than two months after a cesarean section?

Hello doctor, my wife had a successful cesarean section on March 21.
However, she suddenly started bleeding around May 30.
Normally, the lochia should have finished by now.
We have also had intercourse without any issues, and she is still exclusively breastfeeding.
I am unsure if this is related to her diet or individual constitution.
She has been doing some light abdominal exercises, and I am worried that straining her abdomen might have caused the cesarean incision to open.
On June 1, she returned to the hospital where she had the cesarean section for a follow-up appointment, and the doctor performed a procedure to stop the bleeding.
The doctor and nurses mentioned that the blood volume should significantly decrease after the procedure, but since last night, the bleeding has remained almost as heavy as a menstrual period, and there were even blood clots during the cleaning of the surgical site.
The doctor sent the clots for testing, and I am very concerned about the possibility of endometrial cancer, as mentioned online.
I wanted to ask a few questions before the report comes back.
Thank you.

hsiao, 20~29 year old female. Ask Date: 2016/06/02

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the factors contributing to postpartum hemorrhage are numerous.
Based on the description provided, it is not possible to make a determination.
It is recommended to follow the treatment plan provided by the surgical physician and to wait for the pathology report for further treatment guidance.
Thank you! Wishing you safety and health.
Dr.
Zhang

Reply Date: 2016/06/02

More Info

Post-Cesarean complications can be concerning, especially when excessive bleeding occurs weeks after the surgery. In your wife's case, experiencing bleeding two months post-Cesarean section is not typical, and it is understandable that you are worried about the potential causes and implications.

Firstly, it is essential to recognize that after a Cesarean delivery, women typically experience lochia, which is the vaginal discharge that occurs as the body sheds the uterine lining and any remaining blood. This discharge can last for several weeks and usually tapers off. However, if bleeding resumes or becomes heavier after this period, it may indicate an underlying issue that requires medical attention.

There are several potential causes for excessive bleeding two months after a Cesarean section:
1. Retained Products of Conception: Sometimes, fragments of the placenta or other tissues may remain in the uterus after delivery. This can lead to continued bleeding and may require medical intervention to remove these retained products.

2. Infection: An infection in the uterus (endometritis) can cause abnormal bleeding, along with other symptoms such as fever, foul-smelling discharge, and abdominal pain. If your wife has any signs of infection, it is crucial to seek medical care promptly.

3. Uterine Atony: This condition occurs when the uterus does not contract effectively after delivery, leading to excessive bleeding. It is more common in women who have had multiple pregnancies or those with a history of uterine atony.

4. Surgical Complications: In rare cases, complications from the Cesarean section itself, such as a hematoma (a localized collection of blood outside of blood vessels) or issues with the surgical site, can lead to bleeding.

5. Hormonal Changes: Postpartum hormonal fluctuations can sometimes lead to unexpected bleeding, although this is less common.

Regarding your concern about the possibility of endometrial cancer, it is essential to note that while abnormal bleeding can be a symptom of various conditions, including cancer, it is more common for such bleeding to be related to the aforementioned issues, especially in the postpartum period. The fact that your wife is exclusively breastfeeding can also influence her hormonal levels and uterine recovery.

Given that your wife has already undergone a procedure to address the bleeding, it is crucial to monitor her recovery closely. If the bleeding persists or worsens, or if she experiences any additional symptoms such as severe pain, fever, or an increase in the size of blood clots, it is vital to return to the healthcare provider for further evaluation. The results of the blood clot analysis will also provide valuable information regarding the cause of the bleeding.

In the meantime, ensure that your wife is resting adequately and staying hydrated. Encourage her to follow any post-operative care instructions provided by her healthcare team. If she has any dietary restrictions or recommendations from her doctor, it is essential to adhere to those as well.

In conclusion, while excessive bleeding two months after a Cesarean section can be alarming, it is often related to manageable postpartum complications. Continuous communication with her healthcare provider and prompt attention to any concerning symptoms will be key to ensuring her health and recovery.

Similar Q&A

Postpartum Bleeding: Is It Related to Cervical Inflammation or Breastfeeding?

Hello Doctor: I have been experiencing bleeding for about two months after my cesarean section on December 9th. I visited a clinic for examination, took hemostatic medication, and had a Pap smear that showed cervical inflammation. The bleeding stopped for about a month, but it ha...

Dr. Lin Manying reply Obstetrics and Gynecology
Hello: During breastfeeding, most women experience an anovulatory state, which may lead to irregular bleeding. If the bleeding is heavy and lasts for an extended period, please seek medical attention for evaluation. The Hualien Hospital of the Ministry of Health and Welfare cares...

Understanding Abnormal Vaginal Bleeding After C-Section: Causes and Solutions

Five months ago, I had a cesarean section and did not breastfeed. My menstrual cycle returned to normal after a little over two months, but I have been experiencing bleeding outside of my menstrual period. Initially, the blood was light red and had a slight odor, but it has now c...

Dr. Cao Guotao reply Obstetrics and Gynecology
Hello, after giving birth, it is common to experience irregular menstruation. If it does not improve, it is generally recommended to consult an obstetrician-gynecologist for menstrual regulation. Wishing you good health.

Postpartum Complications: When Blood Clots Require Additional Surgery

It has been 9 days since I had a cesarean section at the clinic. During this time, I developed a fever and went to the emergency room. The next day, I visited another hospital where the doctor informed me that there were blood clots. After taking medication for two days, I still ...

Dr. Cao Guotao reply Obstetrics and Gynecology
Hello, if there are blood clots that have not been expelled, they should still be addressed. Wishing you good health.

Is It Normal to Have Light Bleeding Two Months Postpartum?

I had a natural birth with induction. I am currently breastfeeding. Two months postpartum, I am still experiencing light bleeding. Is this normal? I am soaking about half a sanitary napkin each day. If it is not normal, what could be the potential issues?

Dr. Zhuang Zhijian reply Obstetrics and Gynecology
Two months postpartum, having a small amount of bleeding is generally not a concern; it is related to breastfeeding and daily diet. If there is abnormal bleeding, it would be classified as postpartum hemorrhage, which typically occurs earlier and would not extend to this point.