Severe Abdominal Pain and Blood Clots After Childbirth: What to Know

I have a lot of blood clots and severe abdominal pain that makes it difficult to stand?

I just had surgery after giving birth to my third child, who is now 7 months old.
I breastfed for about a month.
After that, my menstrual bleeding and lochia were normal, but this time my period suddenly became irregular and has been flowing for over a month.
I have severe abdominal pain and can feel a large hard mass.
Two days ago, I suddenly passed a blood clot the size of a pudding! I am still bleeding now, and my abdomen feels bloated, and I have a frequent urge to urinate.
What could be wrong with me?

Qiao Qiao, 30~39 year old female. Ask Date: 2016/11/29

Dr. Lü Lizheng reply Obstetrics and Gynecology

There could be many possible reasons for this, including poor uterine contractions, uterine inflammation, or tumors.
Please seek medical attention for a thorough examination.
Sincerely, Dr.
Lu Li-Cheng, Taoyuan Hospital.

Reply Date: 2016/11/29

More Info

Severe abdominal pain and the presence of blood clots after childbirth can be concerning symptoms that warrant immediate medical attention. Given your recent history of childbirth and the symptoms you are experiencing, it is important to understand the potential causes and necessary steps to take.

Firstly, it is not uncommon for women to experience irregularities in their menstrual cycles after childbirth, especially if they are breastfeeding. Breastfeeding can suppress ovulation, leading to irregular periods or even amenorrhea (the absence of menstruation). However, the symptoms you describe—prolonged bleeding, severe abdominal pain, and the passage of large blood clots—are not typical and could indicate a more serious condition.

One possible cause of your symptoms is retained products of conception. After childbirth, if any placental tissue remains in the uterus, it can lead to prolonged bleeding and abdominal pain. This condition can also cause the uterus to become infected, leading to endometritis, which is an infection of the uterine lining. Symptoms of endometritis may include fever, foul-smelling vaginal discharge, and severe abdominal pain.

Another potential issue could be uterine atony, where the uterus fails to contract effectively after delivery. This can lead to excessive bleeding (postpartum hemorrhage) and may require medical intervention. Additionally, the presence of a large hard mass in your abdomen could indicate a hematoma (a localized collection of blood outside of blood vessels) or other complications that may need to be evaluated.

Given that you are experiencing significant pain, prolonged bleeding, and the passage of large blood clots, it is crucial to seek medical attention as soon as possible. A healthcare provider will likely perform a physical examination, possibly including a pelvic exam, and may order imaging studies such as an ultrasound to assess the uterus and check for any retained tissue or other abnormalities.

In the meantime, it is important to monitor your symptoms closely. If you experience any of the following, you should seek emergency care immediately:
- Severe or worsening abdominal pain
- Dizziness or fainting
- Rapid heart rate
- Fever
- Foul-smelling vaginal discharge
- Any signs of shock (such as confusion, weakness, or cold, clammy skin)
In conclusion, while some irregularities in menstrual cycles can occur after childbirth, the symptoms you are experiencing are concerning and should not be ignored. Prompt evaluation by a healthcare professional is essential to rule out serious complications and to ensure your health and well-being. Remember, your health is paramount, and it is always better to err on the side of caution when it comes to postpartum symptoms.

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