Hemorrhage into the cavity of the uterus. The three types of pathologic uterine hemorrhage are essential uterine hemorrhage (metropathia haemorrhagica), which occurs with pelvic, uterine, or cervical diseases; intrapartum hemorrhage, which occurs during labor; and postpartum hemorrhage, which occurs after the third stage of labor. The last may be caused by rupture, lacerations, relaxation of the uterus, hematoma, or retained products of conception, including the placenta or membrane fragments.

ETIOLOGY
Common causes are trauma; congenital abnormalities; pathologic processes (e.g., 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

TREATMENT
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.

Main entry:
hemorrhage