Heavy bleeding began. Causes of bleeding in women of different age groups. Vaginal bleeding: physiological types and causes

Opened internal bleeding is a life-threatening condition that occurs for various reasons. Most often, blood penetrates into the body cavities, as well as the spaces formed by it.

Internal bleeding - what is it?

This is a rapid loss of blood, in which it does not flow out of the body, but ends up in certain places inside. This can be the uterus in women, the space between the joints, stomach, bladder, lungs, intestines.

The symptomatology of this condition depends on the place of its localization. Hemorrhage can occur in the abdominal cavity, intermuscular, etc.

The causes of pathology are, as a rule, of two types: mechanical damage (trauma, shock) and chronic illness.

The danger of such a phenomenon is enhanced by untimely provision of first aid, ignorance of signs to patients, and late diagnosis.

If you seek medical help in time, you can minimize serious complications, determine the localization of bleeding and stop it.

Symptoms of pathology

Intra-abdominal bleeding is one of the most common in mechanical injuries. Symptoms of this form are quite serious.

The patient is very nauseous, bloody vomiting opens, if the pathology in the gastrointestinal tract. Diarrhea occurs when there is internal bleeding in the upper esophagus or small intestine. With a lesion in the large intestine, red discharge will be from the anus.

Gastrointestinal bleeding is one of the most dangerous. Symptoms include fever, and the patient may feel pain in the abdomen. If, then the person is tormented by a strong bloody cough, and the place of accumulation of secretions is the pleural cavity. Shortness of breath appears, there is not enough air.

With uterine blood flows in the middle of the cycle, pours out from the vagina. However, many symptoms in a number of species are not pronounced, which complicates diagnostic measures and leads to a deterioration in the patient's condition.

So, the symptoms of bleeding that occurred inside the body:

Deterioration of health.
Sudden weakness, lethargy, apathy.
Chills, fever, fever, sweating, pallor.
A keen sense of fear.
Nausea, vomiting.
Thirst.
Loss of self-control.
Dizziness, fainting.
Severe coughing up blood.
Dyspnea.
Sudden pains inside, or their complete absence.

If no one is around, you need to call the ambulance service, then take a horizontal position. If possible, you should also call your loved ones if they are nearby. In this case, being alone is not only scary, but also dangerous..

You can not take any pills, drink water. You need to apply ice to the head, chest, stomach. It is important to try not to panic or make sudden movements.

Common signs of bleeding

The main signs for all forms of bleeding that occur inside the body: weakness in the body, lethargy, blood pressure (BP) is significantly reduced, the skin turns pale, cold sweat appears.

A suspicion of such a condition should arise if there were provoking factors (blows with blunt, stabbing objects; injuries), diseases of internal organs were diagnosed.

The patient may lose appetite, feel intense thirst, even faint. How serious a person's condition is can be recognized by certain signs.

If the bleeding is insignificant, then the pulse is intense - up to 80 beats per minute, and blood pressure decreases, the rest of the symptoms may be absent.

If the bleeding is moderate, the upper pressure drops to 90 mm. rt. Art. and below, the heart rate increases. In this case, the skin turns pale, the arms and legs become cold, breathing quickens, nausea, weakness appear, dizzy, all psychomotor reactions slow down.

In severe cases, the patient's pressure drops significantly, the pulse is frequent, breathing is intermittent, cold sweat appears, drowsiness appears, trembling of the arms and legs, darkens in the eyes, vomiting begins, the skin turns pale, cyanosis develops, the person's condition is critical.

If the blood loss is massive, then the pressure drops sharply, the pulse is very fast - up to 160 beats per minute, the patient's consciousness is confused, there is pallor of the skin, delirium, cold sweat, facial features sharpen.

Fatal blood loss: slowing heart rate, low blood pressure, respiratory arrest, convulsions, dilated pupils, dry and pale skin, agony and death.

Views

There are several types of bleeding: arterial, capillary, venous. The cause of the arterial is damage to the artery with a sharp, cutting object, a gunshot wound; blunt blow injury.

It is very difficult to stop bleeding on your own. Blood pours out in a fountain into the organs and out, the victim can lose a critical volume of blood in a few minutes, which will lead to death.

Capillary is common. In this case, the surface of internal organs may bleed, they include the liver, kidneys, spleen.

Symptoms at the very beginning are mild, this complicates the diagnostic process. A stomach ulcer can cause it, and hemorrhage also occurs in the brain tissue. In this case, it is urgent to provide assistance to the patient.

Venous is formed if the walls of the veins are damaged. The patient instantly develops symptoms of anemia, anemia, and a state of shock. With venous bleeding, dangerous conditions can occur in which the escaping fluid accumulates in the pleural and retroperitoneal cavities.

Causes

Why does such a pathology arise? The factors of its formation may be different, at first glance, even impossible. Among them:

poor blood clotting (heredity);
fractures of the ribs, mechanical trauma, wounds;
infections, pathologies, cirrhosis of the liver, ulcers, tuberculosis, improper arrangement of internal organs, their displacement, increase due to illness;
during pregnancy - rupture of the ovary, cysts, ectopic location of the ovum;
disintegration of a malignant tumor;
arterial hypertension, atherosclerosis.

There can be many more reasons, so it is important to respond in time to sudden changes in well-being, especially if provoking factors have taken place, and chronic diseases of the intestines, stomach and other vital organs have been diagnosed.

Methods for determining the location of internal damage

If a person feels bad, how to find an objective sign of internal bleeding and recognize its source?

If a hemorrhage occurs in the abdominal cavity, followed by a rupture of the spleen or liver, then the general symptoms include dizziness, weakness, low blood pressure and tachycardia. The patient has a heaviness in the abdomen, pain in the left and right shoulder, palpation of the peritoneum is soreness in the upper part.

It is difficult, but possible, to independently determine bleeding and its nature..

If there is a rupture of the tubes or ovaries, then there is pain in the lower abdomen, in the anus, deterioration of health, there is red discharge from the genitals.

With bleeding that occurs in the retroperitoneal space (ruptures of the kidneys, aorta), the patient has a general symptomatology, which is not very pronounced.

There is pain in the lumbar spine, if you knock lightly on the spine, it will intensify.

If the lesion is in the stomach, intestines, then there is bloody vomiting or diarrhea, no abdominal pain.

How to stop the blood

If there is a suspicion of internal hemorrhage, then first aid at home will play an important role in the outcome of the situation. Before the arrival of the doctors, the patient should be laid to relax the muscles. If the victim has a cough, then his body is given a semi-sitting position.

It is imperative to open a window in the room, apply cold to the alleged place of damage.

It is important to control a person's breathing, pulse. If he gets worse, artificial respiration should be given.

Do not give painkillers, water, medicines, knead the body, tightly bandage the site of injury, move the victim.

Drug therapy

The best treatment for internal hemorrhages is timely assistance and surgery. Therapy of this pathology is carried out in a hospital, in the departments of gynecology, surgery, neurosurgery, depending on the source of blood loss.

Doctors first stop the blood, compensate for its loss, and improve circulation. Physical solutions, glucose are used, other medications are prescribed in accordance with the patient's condition.

When is surgery required

Surgical intervention is needed if the patient's condition is critical. After the person has received first aid, he is hospitalized. Experts take into account the source of bleeding, and then take action.

If the place where the fluid is concentrated is the pleural cavity, then traumatologists are involved in the treatment, if the lungs are treated by surgeons, with intracranial damage - by neurosurgeons, with uterine damage - by gynecologists.

Surgery is required if the source is in the gastrointestinal tract.

The main task of the doctor is to stop bleeding, compensate for the amount of loss and improve blood supply. Patients often experience shock, in which the internal organs do not receive enough oxygen.

In such cases, patients are given a transfusion, glucose and saline are administered. If the case is severe, the blood is stopped with cauterization, but surgery is most often required.

In case of pulmonary hemorrhage, bronchial tamponade is performed. If the abdominal part is filled with blood, then an urgent laparotomy is performed. If the damage is intracranial, then trepanation is done. In case of an ulcer, the damaged vessels are removed, with cracks in the intestine, an operation is performed and they are sutured.

If a woman has an ectopic pregnancy (a tube ruptured), then the pathology is eliminated only by surgery.

Internal bleeding during pregnancy

This condition is also called premature placental abruption, and it requires urgent specialist intervention.

Clinical manifestations of this condition:

discharge can be abundant, medium, absent altogether;
pain in the lower abdomen, the uterus "turns to stone", it is easy to feel on palpation;
the cardiac activity of the fetus is disturbed, hypoxia occurs (determined by ultrasound);
the woman's body temperature rises.
the state of health worsens.

Detachment is provoked by the use of alcohol by the mother, drug addiction, smoking, anemia, low red blood cell count, abdominal trauma, allergy to drugs, fluctuations in blood pressure.

Effects

Any bleeding is a threat to a person, and internal - even more so. In this state, blood pressure suddenly drops, hemoglobin decreases.

If blood gets into the cavities of the internal organs, their activity is disrupted. If at the same time the vessels are compressed, then tissue necrosis occurs. The blood that is in the cavities of the organs for some time (not circulating) becomes a suitable place for the multiplication of bacteria and the development of infections.

If the patient was not treated in time, then there is a high probability of death. The body is drained of blood, the activity of the heart and brain is disrupted. If a person manages to help, then a long recovery period awaits him, and everything depends on the severity of the condition.

- pathological bleeding from the uterus associated with a violation of the production of sex hormones by the endocrine glands. Distinguish between juvenile bleeding (during puberty), climacteric bleeding (in the stage of extinction of ovarian function), bleeding of the reproductive period. It is expressed by an increase in the amount of blood lost during menstruation or an increase in the duration of menstruation. May manifest as metrorrhagia - acyclic bleeding. Characterized by the alternation of periods of amenorrhea (from 6 weeks to 2 or more months) followed by bleeding of varying strength and duration. Leads to the development of anemia.

General information

Dysfunctional uterine bleeding (the accepted abbreviation is DMC) is the main manifestation of ovarian dysfunction syndrome. Dysfunctional uterine bleeding is characterized by acyclicity, prolonged delays in menstruation (1.5-6 months) and prolonged blood loss (more than 7 days). There are dysfunctional uterine bleeding of juvenile (12-18 years old), reproductive (18-45 years old) and menopausal (45-55 years old) age periods. Uterine bleeding is one of the most common hormonal pathologies of the female genital area.

Juvenile dysfunctional uterine bleeding is usually caused by the unformed cyclic function of the hypothalamus-pituitary-ovary-uterus. In childbearing age, frequent causes of ovarian dysfunction and uterine bleeding are inflammatory processes of the reproductive system, diseases of the endocrine glands, surgical termination of pregnancy, stress, etc., in menopause - dysregulation of the menstrual cycle due to the extinction of hormonal function.

On the basis of the presence or absence of ovulation, ovulatory and anovulatory uterine bleeding are distinguished, the latter accounting for about 80%. The clinical picture of uterine bleeding at any age is characterized by prolonged spotting that appears after a significant delay in menstruation and is accompanied by signs of anemia: pallor, dizziness, weakness, headaches, fatigue, and a decrease in blood pressure.

Mechanism of development of DMK

Dysfunctional uterine bleeding develops as a result of a violation of hormonal regulation of the function of the ovaries by the hypothalamic-pituitary system. Disruption of the secretion of gonadotropic (follicle-stimulating and luteinizing) hormones of the pituitary gland, which stimulate follicle maturation and ovulation, leads to disruptions in folliculogenesis and menstrual function. At the same time, in the ovary, the follicle either does not mature (follicle atresia), or matures, but without ovulation (follicle persistence), and, therefore, the corpus luteum does not form either. In both cases, the body is in a state of hyperestrogenism, that is, the uterus is influenced by estrogens, since in the absence of the corpus luteum, progesterone is not produced. The uterine cycle is disrupted: there is a long-term, excessive growth of the endometrium (hyperplasia), and then its rejection, which is accompanied by profuse and prolonged uterine bleeding.

The duration and intensity of uterine bleeding is influenced by hemostasis factors (platelet aggregation, fibrinolytic activity and vascular spasticity), which are impaired in DMK. Uterine bleeding can stop on its own after an indefinitely long time, but, as a rule, it reappears, so the main therapeutic task is to prevent the recurrence of DMC. In addition, hyperestrogenism in dysfunctional uterine bleeding is a risk factor for the development of adenocarcinoma, uterine fibroids, fibrocystic mastopathy, endometriosis, and breast cancer.

Juvenile DMK

Causes

In the juvenile (puberty) period, uterine bleeding occurs more often than other gynecological pathologies - in almost 20% of cases. Disruption of the formation of hormonal regulation at this age is facilitated by physical and mental trauma, unfavorable living conditions, overwork, hypovitaminosis, dysfunction of the adrenal cortex and / or thyroid gland. Children's infections (chickenpox, measles, mumps, whooping cough, rubella), acute respiratory infections, chronic tonsillitis, complicated pregnancy and childbirth in the mother, etc. also play a provoking role in the development of juvenile uterine bleeding.

Diagnostics

When diagnosing juvenile uterine bleeding, the following are taken into account:

history data (date of menarche, last menstrual period and onset of bleeding)
development of secondary sexual characteristics, physical development, bone age
hemoglobin level and blood clotting factors (complete blood count, platelets, coagulogram, prothrombin index, clotting time and bleeding time)
indicators of the level of hormones (prolactin, LH, FSH, estrogen, progesterone, cortisol, testosterone, T3, TSH, T4) in the blood serum
expert opinion: consultation of a gynecologist, endocrinologist, neurologist, ophthalmologist
indicators of basal temperature between periods (a single-phase menstrual cycle is characterized by a monotonous basal temperature)
the state of the endometrium and ovaries based on ultrasound data of the pelvic organs (using a rectal sensor in virgins or a vaginal one in girls who are sexually active). An echogram of the ovaries with juvenile uterine bleeding shows an increase in the volume of the ovaries in the intermenstrual period
the state of the regulatory hypothalamic-pituitary system according to the X-ray of the skull with the projection of the sella turcica, echoencephalography, EEG, CT or MRI of the brain (in order to exclude tumor lesions of the pituitary gland)
Ultrasound of the thyroid and adrenal glands with Doppler
Ultrasound control of ovulation (to visualize atresia or persistence of the follicle, mature follicle, ovulation, corpus luteum formation)

Treatment

The primary task in the treatment of uterine bleeding is to carry out hemostatic measures. Further treatment tactics are aimed at preventing recurrent uterine bleeding and normalizing the menstrual cycle. Modern gynecology has in its arsenal several ways to stop dysfunctional uterine bleeding, both conservative and surgical. The choice of the method of hemostatic therapy is determined by the general condition of the patient and the amount of blood loss. With moderate anemia (with hemoglobin above 100 g / l), symptomatic hemostatic (menadione, etamsylate, ascorutin, aminocaproic acid) and uterine-reducing (oxytocin) drugs are used.

In case of ineffectiveness of non-hormonal hemostasis, progesterone preparations are prescribed (ethinyl estradiol, ethinyl estradiol, levonorgestrel, norethisterone). Bloody discharge usually stops 5-6 days after the end of the drug. Abundant and prolonged uterine bleeding leading to a progressive deterioration of the condition (severe anemia with Hb less than 70 g / l, weakness, dizziness, fainting) is an indication for hysteroscopy with separate diagnostic curettage and pathomorphological examination of scraping. A contraindication to curettage of the uterine cavity is a blood clotting disorder.

In parallel with hemostasis, antianemic therapy is carried out: iron preparations, folic acid, vitamin B12, vitamin C, vitamin B6, vitamin P, transfusion of erythrocyte mass and fresh frozen plasma. Further prevention of uterine bleeding includes taking low-dose progestational drugs (gestodene, desogestrel, norgestimate in combination with ethinyl estradiol; dydrogesterone, norethisterone). In the prevention of uterine bleeding, general hardening, sanitation of chronic infectious foci and proper nutrition are also important. Adequate measures for the prevention and treatment of juvenile uterine bleeding restore the cyclic functioning of all parts of the reproductive system.

DMC of the reproductive period

Causes

In the reproductive period, dysfunctional uterine bleeding accounts for 4-5% of all gynecological diseases. The factors that cause ovarian dysfunction and uterine bleeding are neuropsychic reactions (stress, overwork), climate change, occupational hazards, infections and intoxication, abortions, and some medicinal substances that cause primary disorders at the level of the hypothalamus-pituitary gland. Infectious and inflammatory processes lead to disorders in the ovaries, contributing to the thickening of the ovarian capsule and a decrease in the sensitivity of the ovarian tissue to gonadotropins.

Diagnostics

When diagnosing uterine bleeding, organic pathology of the genitals (tumors, endometriosis, traumatic injuries, spontaneous abortion, ectopic pregnancy, etc.), diseases of the hematopoietic organs, liver, endocrine glands, heart and blood vessels should be excluded. In addition to general clinical methods for diagnosing uterine bleeding (history taking, gynecological examination), hysteroscopy and separate diagnostic curettage of the endometrium with histological examination of the material are used. Further diagnostic measures are the same as for juvenile uterine bleeding.

Treatment

Therapeutic tactics for uterine bleeding of the reproductive period is determined by the results of the histological result of the scrapings taken. When recurrent bleeding occurs, hormonal and non-hormonal hemostasis is performed. In the future, to correct the revealed dysfunction, hormonal treatment is prescribed, which helps to regulate menstrual function, prevent recurrence of uterine bleeding.

Non-specific treatment of uterine bleeding includes the normalization of the neuropsychic state, treatment of all background diseases, and removal of intoxication. This is facilitated by psychotherapeutic techniques, vitamins, sedatives. For anemia, iron supplements are prescribed. Uterine bleeding of reproductive age with improperly selected hormone therapy or a specific reason may recur.

DMC of the climacteric period

Causes

Premenopausal uterine bleeding occurs in 15% of cases of the number of gynecological pathology in women in the climacteric period. With age, the amount of gonadotropins secreted by the pituitary gland decreases, their release becomes irregular, which causes a violation of the ovarian cycle (folliculogenesis, ovulation, development of the corpus luteum). Deficiency of progesterone leads to the development of hyperestrogenism and hyperplastic proliferation of the endometrium. Climacteric uterine bleeding in 30% develops against the background of climacteric syndrome.

Diagnostics

The peculiarities of the diagnosis of menopausal uterine bleeding consist in the need to differentiate them from menstruation, which at this age become irregular and proceed as metrorrhagia. To exclude the pathology that caused uterine bleeding, hysteroscopy is best done twice: before and after diagnostic curettage.

After scraping, when examining the uterine cavity, it is possible to identify areas of endometriosis, small submucous fibroids, uterine polyps. In rare cases, a hormone-active ovarian tumor becomes the cause of uterine bleeding. This pathology can be identified by ultrasound, nuclear magnetic or computed tomography. Methods for diagnosing uterine bleeding are common for different types and are determined by the doctor individually.

Treatment

Therapy of dysfunctional uterine bleeding in menopause is aimed at suppressing hormonal and menstrual functions, that is, to induce menopause. Stopping bleeding during uterine bleeding of the climacteric period is performed exclusively by a surgical method - by means of therapeutic and diagnostic curettage and hysteroscopy. Expectant tactics and conservative hemostasis (especially hormonal) are erroneous. Sometimes cryodestruction of the endometrium or surgical removal of the uterus is performed - supravaginal amputation of the uterus, hysterectomy.

Prevention of DMK

Prevention of dysfunctional uterine bleeding should be started at the stage of intrauterine development of the fetus, that is, during the period of pregnancy. In childhood and adolescence, it is important to pay attention to general strengthening and general health measures, prevention or timely treatment of diseases, especially of the reproductive system, and prevention of abortion.

If dysfunction and uterine bleeding still develop, then further measures should be aimed at restoring the regularity of the menstrual cycle and preventing recurrence of bleeding. For this purpose, the appointment of oral estrogen-progestogenic contraceptives is shown according to the scheme: the first 3 cycles - from 5 to 25 days, the next 3 cycles - from 16 to 25 days of menstrual bleeding. Pure gestagenic drugs (norkolut, dyufaston) are prescribed for uterine bleeding from the 16th to the 25th day of the menstrual cycle for 4 to 6 months.

The use of hormonal contraceptives not only reduces the frequency of abortions and the occurrence of hormonal imbalance, but also prevents the subsequent development of anovulatory forms of infertility, endometrial adenocarcinoma, and breast cancer. Patients with dysfunctional uterine bleeding should be registered with a gynecologist.

The body of humans and mammals is permeated with thousands of small, medium and large vessels, which contain a valuable fluid that performs a huge number of functions - blood. During his life, a person experiences the influence of a considerable number of harmful factors, among them such traumatic influences as mechanical tissue damage are most often encountered. As a result, bleeding occurs.

What it is? The medical science "pathological physiology" gives such a definition to this condition: "this is the release of blood from a damaged vessel." At the same time, it pours out or into the body cavity (abdominal, chest or pelvis) or organ. If it remains in the tissue, soaking it, it is called hemorrhage, if it accumulates freely in it, it is called a hematoma. A condition in which blood vessels are damaged, most often suddenly arising, and with a strong rapid outflow of vital fluid, a person can die. That is why first aid for bleeding often saves him life, and it would be nice for everyone to know the basics. After all, such situations do not always occur when there are medical workers or at least just specially trained people nearby.

What types of bleeding are there and why do they occur?

There are many classifications of this pathological condition, and experts teach them all. However, we are interested in the division of bleeding into varieties, first of all, from a practical point of view. For the successful provision of first aid, the following classification is relevant. It shows the types of bleeding depending on the nature of the damaged vessel.

Arterial bleeding

It comes from arteries containing oxygenated blood flowing from the lungs to all organs and tissues. This is a serious problem, since these vessels are usually located deep in the tissues, close to the bones, and situations when they are injured are the result of very strong influences. Sometimes this type of bleeding stops on its own, since the arteries have a pronounced muscular membrane. When such a vessel is injured, the latter spasms.

Venous bleeding

Its source is venous vessels. Through them, blood containing metabolic products and carbon dioxide flows from cells and tissues to the heart and further to the lungs. Veins are located more superficially than arteries, so they are damaged more often. These vessels do not contract during injury, but they can stick together, since their walls are thinner and their diameter is larger than that of arteries.

Capillary bleeding

Blood flows from small vessels, most often the skin and mucous membranes, usually this bleeding is insignificant. Although it can be frighteningly profuse with a wide wound, since the number of capillaries in the tissues of the body is very large.

Parenchymal bleeding

Separately, the so-called parenchymal bleeding is also isolated. The organs of the body are hollow, in fact, they are "bags" with multilayer walls - and parenchymal, which consist of tissue. The latter include the liver, spleen, kidneys, lungs, pancreas. Usually, this type of blood flow can only be seen by a surgeon at an operation, since all parenchymal organs are "hidden" deep in the body. By the type of the damaged vessel, such bleeding cannot be determined, because in the tissue of the organ there are all their varieties and all of them are injured at once. This is mixed bleeding. The latter is also observed with extensive wounds of the limbs, since the veins and arteries lie side by side.

Depending on whether blood remains in the body cavity or organ or is poured out of the body, bleeding is emitted:

Internal. Blood does not come out, lingering inside: in the cavity of the abdominal, chest, pelvic, joint (WWII), ventricles of the brain. A dangerous type of blood loss that is difficult to diagnose and treat, since there are no external signs of bleeding. There are only general manifestations of its loss and symptoms of significant dysfunction of the organ (s).
External bleeding. Blood is poured into the external environment, most often the causes of this condition are injuries and various ailments that affect individual organs and systems. These bleeding can be from the skin and mucous membranes, gastric and intestinal, from the urinary system. In this case, the visible outpourings of blood are called explicit, and those that occur in a hollow organ communicating with the external environment are called hidden. The latter may not appear immediately after the onset of bleeding, because it takes time for blood to come out, for example, from a long digestive tube.

Usually, bleeding with clots is external, hidden or internal, when blood is retained inside the organ and partially clotted.

Sharp. In this case, a large amount of blood is lost in a short period of time, usually it occurs suddenly as a result of injury. As a result, a person develops an acute state (anemia).
Chronic. Long-term loss of small volumes of this biological fluid, the cause is usually chronic diseases of organs with ulceration of the vessels of their walls. Cause a state of chronic anemia.

Video: bleeding in the "School of Doctor Komarovsky"

The main causes of bleeding

What can cause bleeding? Here it is pertinent to note that there are also two fundamentally different types of them, based on the factor whether a normal vessel is damaged or a pathological condition has arisen against the background of the destruction of the altered vascular wall. In the first case, bleeding is called mechanical, in the second - pathological.

The following main causes of bleeding can be distinguished:

Traumatic injury. They can be thermal (from exposure to critical temperatures), mechanical (with bone fracture, injury, bruise). The latter occur in various extreme situations: road accidents, railway and plane crashes, falls from a height, fights involving piercing and cutting objects, gunshot wounds. There are also industrial and domestic injuries.
Vascular diseases, including tumors (purulent tissue lesions involving blood vessels, atherosclerosis, hemangiosarcoma).
Diseases of the blood coagulation system and liver (, fibrinogen deficiency, vitamin K hypovitaminosis, hepatitis, cirrhosis).
Common diseases. For example, diabetes mellitus, infections (viral, sepsis), lack of vitamins, poisoning cause damage to the vascular walls throughout the body, as a result of which plasma and blood cells leak through them and bleeding occurs.
Ailments affecting various organs. Leakage of blood from the lungs can cause tuberculosis, cancer; from the rectum - tumors, hemorrhoids, cracks; from the digestive tract - stomach and intestinal ulcers, polyps, diverticula, tumors; from the uterus - endometriosis, polyps, inflammation, neoplasms.

What is the risk of bleeding for a person?

One of the most important, but by no means the only function of blood, is to carry oxygen and nutrients. She delivers them to the tissues, and from them takes away metabolic products and carbon dioxide. With significant bleeding, there is a significant loss of this substance necessary for the body. The nervous system and heart muscle are very sensitive to oxygen deficiency. Death of the brain with a complete cessation of blood supply to it occurs in humans and animals in just 5-6 minutes.

However, besides the direct loss of the precious oxygen-containing liquid, there is another problem. The fact is that it keeps the vessels in good shape and with a significant loss of it, the latter subside. In this case, the blood remaining in the human body, the oxygen contained, becomes ineffective and can help little. This condition is very dangerous, it is called vascular shock or collapse. It occurs with acute strong.

The consequences described above are life-threatening for the patient and develop very quickly after bleeding.

Blood performs a huge number of functions, among them it is very important to maintain the balance of the internal environment of the body, as well as to ensure the connection of organs and tissues with each other by transferring various biologically active substances. Thus, billions of body cells exchange information and, as a result, can work harmoniously. Bleeding, to one degree or another, disrupts the constancy of the internal environment of the body and the functions of all its organs.

Often, blood loss does not directly threaten the patient's life; this is observed in many diseases. In such cases, the blood loss is chronic and mild. Replacement of the outflowing blood occurs by the synthesis of plasma proteins by the liver and bone marrow - cellular elements. Bleeding becomes an important diagnostic feature for recognizing ailment.

Signs of bleeding

General

Patient complaints:

Weakness, unmotivated drowsiness;
Dizziness;
Thirst;
Feeling of palpitations and shortness of breath.

External symptoms of blood loss, which are observed with any type of bleeding, are as follows:

Pallor of the skin and mucous membranes;
Cold sweat;
Increased heart rate;
Dyspnea;
Disorders of urination up to a complete lack of urine;
Drop in blood pressure;
Frequent, weak pulse;
Disturbance of consciousness up to its loss.

Local

External outpouring of blood

The main local symptom is the presence of a wound on the surface of the skin or mucous membrane and the visible bleeding from it. However, the nature of bleeding is different and is in direct proportion to the type of vessel.

Capillary is manifested by that blood collects in large drops, oozing from the entire surface of the wound. Its loss per unit of time is usually small. Its color is red.
Signs of venous bleeding: blood can flow out quite quickly when a large vein is injured or several at once, it flows from the wound in strips. Its color is dark red, sometimes burgundy. If large veins in the upper body are damaged, intermittent bleeding from the wound may occur (however the rhythm is synchronized not with the pulse, but with the breath).
Signs of arterial bleeding: blood pours out from the site of injury with pulsating jolts - "fountains" (their frequency and rhythm coincide with heartbeats and pulse), its color is bright scarlet, red. Blood loss per unit time is usually rapid and significant.

Manifestations of latent bleeding

From the lungs - blood is excreted with a cough (a symptom of hemoptysis), it is frothy, the color is bright red.
From the stomach - the color is brown (hydrochloric acid of gastric juice reacts with blood, the latter changes color). There may be clots.
From the intestines - the feces become dark brown or black in color and a viscous, viscous consistency (tarry stools).
From the kidneys and urinary tract - the urine becomes red (from a brick shade to brown with "rags" - clots and pieces of tissue).
From the uterus and genitals - the blood is red, often there are pieces of the mucous membrane in the secretions.
From the rectum - red blood drops can be found in the feces.

Signs of internal bleeding

There is no bleeding into the environment. There are general symptoms of blood loss.
Local manifestations will depend on the site of damage to the vessel and in which body cavity the blood accumulates.
- loss of consciousness or confusion, local impairment of motor functions and / or sensitivity, coma.
In the pleural cavity - chest pains, shortness of breath.
In the abdominal cavity - abdominal pain, vomiting and nausea, muscle tension in the abdominal wall.
In the joint cavity - its swelling, pain on palpation and active movements.

Can the body cope with bleeding?

Nature has provided such a possibility that fragile and delicate living tissues of the body will be injured during a long life. This means that a mechanism is needed to resist the outflow of blood from damaged vessels. And people have it. The blood plasma, that is, the liquid part that does not contain cells, contains biologically active substances - special proteins. Together, they make up the blood coagulation system. It is helped by special blood cells - platelets. The result of complex multistage blood clotting processes is the formation of a blood clot - a small clot that clogs the affected vessel.

In laboratory practice, there are special indicators that show the state of the blood coagulation system:

Duration of bleeding. An indicator of the duration of the effusion of blood from a small standard injury inflicted with a special stylet on a finger or earlobe.
Clotting time - shows how long it takes for blood to clot and a blood clot forms. It is carried out in test tubes.

The norm for the duration of bleeding is three minutes, the time is 2-5 minutes (according to Sukharev), 8-12 minutes (according to Lee-White).

Often, trauma or damage to a vessel by a pathological process is too extensive and the natural mechanisms for stopping bleeding do not cope, or a person simply does not have time to wait due to the threat to life. Without being a specialist, it is difficult to assess the condition of the victim, and the treatment tactics will be different depending on the cause.

Therefore, a patient with severe bleeding from a vein or artery must be urgently taken to a hospital. Before that, he must be given emergency assistance. To do this, you need to stop the bleeding. Usually this is a temporary cessation of blood flow from the vessel.

First aid

What are the known methods for temporarily stopping bleeding? Here they are:

Pressure (pressing the vessel in the wound, applying a pressure bandage).
Applying a hemostatic sponge, ice, irrigation with hydrogen peroxide (for capillary bleeding).
Very strong flexion of the limb.
Dense tamponade with a bandage, gauze, cotton wool (for the nasal cavity, deep external wounds).
The imposition of a hemostatic tourniquet.

Methods for the final stop of bleeding, which can only be performed by a doctor and in a medical institution, are:

Mechanical: dressing a vessel in a wound, making a vascular suture, stitching a tissue together with a vessel.
Chemicals: drugs that increase clotting and vasoconstrictor (calcium chloride, epinephrine, aminocaproic acid)
Thermal: electrocoagulation.
Biological (to stop capillary and parenchymal bleeding during operations): fibrin films, hemostatic sponges, hemming of the body's own tissues (omentum, muscle, adipose tissue).
Embolization of the vessel (introduction of small air bubbles into it).
Removal of the affected organ or part of it.

It is very important to determine the type of the damaged vessel, because the ways of stopping the outpouring of blood from it will depend on it.

First aid for arterial bleeding

The application of a tourniquet is very effective if the vessel of the limb is damaged. The method of pressure and tight wound tamponade is also used.

Harness imposition rules

While it is being prepared, you need to press the artery to the bones above the wound with your fist or fingers, remember that when a large vessel is injured, the count goes on for minutes. The shoulder artery is pressed against the shoulder bone along its inner surface, the elbow - in the elbow bend, the femoral - in the inguinal bend, the lower leg - in the popliteal fossa, axillary - in the hollow of the same name.

Raise the injured leg or arm. A tourniquet is applied, tightly tightening and placing a towel or rag between it and the skin. If there is no special rubber band, you can use a regular bandage, scarf, thin rubber hose, trouser belt, handkerchief, or even a rope. Then it is tied around the limb loosely, a stick is inserted into the loop and twisted until the desired compression. The criterion for the correct application of the tourniquet is the cessation of bleeding. The time of his stay on the limb: no more than two hours in the summer and half an hour in the winter... To fix the moment of vascular clamping, time is written on a piece of paper and fixed on the affected limb.

Danger

The problem is that it is impossible to apply a tourniquet for more than the above-mentioned time interval due to circulatory disorders in the injured leg or arm, the tissues die off. The function of the limb then will not be fully restored, sometimes amputation becomes necessary. In addition, there is a danger of development in the area of damage (bacteria that live in the soil and multiply in living tissues in the absence of oxygen enter the wound). If the person has not yet been delivered to the hospital within the specified time, in any case, the tourniquet must be loosened for a few minutes. The wound is clamped during them using a clean cloth..

If the carotid artery is injured and bleeds from it, it is necessary to squeeze it with a finger and tamponade the wound with a sterile dressing material. A tourniquet can be applied to the neck; for this, a special technique is used to prevent the victim from suffocating. Raise the arm on the side opposite to the injury, and pull the neck with a tourniquet below the site of injury along with the limb.

Video: emergency care for severe bleeding

Venous bleeding

With venous bleeding, tight bandaging or a tourniquet works well. The peculiarity of the latter's technique is that its location is not higher than the site of injury, as in an artery injury, but, on the contrary, lower.

For any method of stopping bleeding, the wound itself is covered with a sterile napkin or clean cloth. If pain medication is available, the victim can be given an injection or a pill if awake. A person lying on the ground should be covered to prevent hypothermia. Do not move or turn over the victim.

If internal bleeding from trauma is suspected, the patient should be kept at rest and taken to the hospital as soon as possible.

Video: first aid for venous bleeding

Capillary bleeding

For capillary bleeding, the method of pressure is used, including with the palm or fingers, bandaging, hemostatic sponges, cold objects. With adequate work of the coagulation system, the temporary cessation of bleeding becomes permanent.

Therapy after stopping bleeding in a hospital

It is imperative to use blood coagulation improving drugs, blood substitutes, whole blood / plasma / platelet suspension. Intravenous fluid therapy is also needed to restore ion balance. Since after serious traumatic accidents, bleeding is usually far from the only problem, in parallel with the work to stop it, doctors carry out emergency diagnostics and therapy of concomitant disorders.

The main thing is not to lose your head if some of the people around you are in trouble, and the person has bleeding. In order to cope with it, you can use materials from a car first aid kit, things from your own bag, items of clothing or household items.

The task and duty of every normal person is providing first aid to the victim, which consists in temporarily stopping his loss of blood... And then you should immediately take the patient to a medical institution on their own or urgently call an ambulance.

Uterine bleeding- discharge of blood from the uterus. Observed in women:

normal - with menstruation (this bleeding is not dangerous, although it is abundant with clots);
in case of pathology, an urgent appeal to a gynecologist is necessary, since this type of blood loss cannot be stopped at home.

Excessive bleeding from the uterus is a dangerous sign of trouble in the female body. In no case can you ignore this symptom, because a person can weaken and die from blood loss. Severe blood loss through damaged uterine tissue is most often observed in complicated labor with tears and ruptures of the muscular uterine walls.

Let's talk about how to stop profuse uterine bleeding with clots during menstruation and pathologies from the uterus at home.

Attention!!!

Always in case of rapid blood loss, urgently call an ambulance and take first aid measures to stop or at least reduce the intensity of bleeding!

Bleeding from the uterus: norm and pathology

Uterine bleeding occurs monthly in healthy women of reproductive age. Consider the signs of the difference between menstruation and pathological hemorrhage:

regularity - menstruation occurs once every 21-30 days, not more often;
abundance - during menstruation, the release of blood from the uterus in the first three days increases and then decreases;
soreness of sensations - with menstruation, as a rule, there is little discomfort or no pain;
duration - menstruation lasts up to 7 days, and pathological bleeding is usually longer.

Bleeding can also occur in girls who have not yet entered puberty.

Hemorrhages: causes of development

Abnormal discharge of blood from the uterus can appear at any age. Usually, in girls and young girls, this condition does not require serious treatment. But with menopause, the outflow of blood from the genitals in a woman is an alarming sign. I need an urgent consultation with a gynecologist!

Pathological profuse and moderate uterine bleeding causes:

functional malfunctions of the physiological complex hypothalamus-pituitary-ovaries;
hyperplasia (proliferation) of the endometrium (accompanied by prolonged profuse bleeding), because with endometrial hyperplasia, the uterine mucosa is rejected;
diseases of the uterus and its appendages, including neoplasms (intensively bleeding with uterine myoma);
somatic pathologies (liver disease);
low blood clotting (here usually uterine bleeding is combined with hemorrhages from the nose, gums, cuts);
disorders in the activity of the thyroid gland;
complicated pregnancy and difficult childbirth;
anemia;
the use of contraceptives - oral and intrauterine devices, blood thinners;
uncontrolled, untreated hypertension.

First aid: how to stop uterine bleeding at home

If signs and symptoms of uterine bleeding are found, urgently call an ambulance. Especially if a pregnant woman has bleeding.

External signs: what it looks like

The woman outwardly looks very pale, weak, her pulse is weak, and her blood pressure is low.

Subjective symptoms: what he complains about, what he reports

The woman experiences (reports) severe weakness, fainting.

What you need and can do

First aid for uterine bleeding at home is, if not completely stop the blood, then at least slow down its loss. It is necessary to call a gynecologist or an ambulance paramedic, or deliver her to the first aid point, gynecological department (surgical) of the hospital at the place of residence (or location).

It may not be possible to find out the reason why the blood is flowing without a specialist examination.

Lay down the patient, provide her peace. It is recommended to raise the legs for better blood supply to vital organs, to prevent loss of consciousness.
Place an ice pack (a plastic bottle filled with frozen or cold water) on the woman's lower abdomen. After 15 minutes, take a five minute break.
Give the patient an abundant warm drink - to replenish fluid: black tea, rosehip broth, plain water.
Give a styptic ( Dicinon).

What not to do

warm your stomach;
take a hot bath;
drink medications that cause uterine contraction;
douche.

Be careful about self-medication due to side effects. After the arrival of the ambulance team, further therapy is usually carried out in a hospital setting.

After childbirth, bleeding from the uterus at low pressure is often caused by poor tone of the uterine muscles.

Medication treatment

In case of uterine bleeding, hemostatic drugs are used along with hormonal agents.

Typically, these drugs are prescribed in the form of intramuscular injections or intravenous infusions in saline (put the "system"):

Aminocaproic acid;
Vikasol;
Dicinon;
Calcium chloride;
Contrikal;
Oxytocin;
Tranexam;
Fibrinogen;
Etamsilat.

With profuse bleeding from the uterus with clots, the same drugs are used intravenously. This way they act faster.

Folk remedies at home

For uncomplicated and non-dangerous uterine bleeding, with the permission of a gynecologist, some folk remedies are used at home.

Home remedies in the form of medicinal plants and herbs are unacceptable for uncontrolled use. The daily intake is limited to three tablespoons.

The combination of official medical therapies and treatment with traditional medicine helps to quickly stop blood and prevent recurrence of the disease.

Highlander pochechuyny

The kidney contains:

acids (acetic and malic);
vitamins K and C;
tannin (phenolic compound with tanning properties);
essential oils.

The herb allows you to strengthen the walls of blood vessels, reduce pressure and increase blood viscosity.

In order to prepare the infusion, take 3 teaspoons of the mountaineer, pour 1 glass of boiling water and leave for 2 hours, wrapping it up. Apply the infusion inside three times a day, 1 tablespoon on an empty stomach.

Contraindications: cannot be used

when carrying a child;
with renal pathologies;
with diseases of the urinary system;
with thrombosis and cardiovascular disorders.

Water pepper

This plant has a beneficial effect on the reproductive organs of a woman thanks to its components:

organic acids;
tannin;
vitamin K;
cardiac glycosides (rutin, polyhoperine);
essential oils.

In case of uterine bleeding, tincture of water pepper helps to improve blood clotting, tones up the vessels of the uterus, and stabilizes the work of its smooth muscles. The tincture is very effective for bleeding after childbirth.

Cooking recipe: the raw materials are crushed, 1 tablespoon of herbs is poured with 1 glass of boiling water. 2 hours insist, wrapping the vessel, filter. Take a tincture of water pepper before meals, 1 tablespoon three times a day.

Remember: Water pepper is contraindicated for girls under 12 years old and pregnant women.

Contraindications: cannot be used with

ischemia;
hypertension;
thrombophlebitis;
kidney disease;
pathologies of the brain;
individual intolerance.

A ready-made liquid extract of water pepper can be purchased at a pharmacy. True, for those who are contraindicated in ethyl alcohol, there is an alternative remedy: tablets Hydropiperine.

Shepherd's bag

Preparations made on the basis of a medicinal herb - shepherd's purse - are widely used for uterine bleeding. This medicinal plant contains:

alkaloids;
organic acids;
glycosides;
choline;
vitamin C;
tannin;
riboflavin.

The components of the shepherd's purse stimulate the secretion of fibrin (this improves blood clotting and causes uterine contractions).

Contraindications:

pregnancy,
haemorrhoids.

Nettle

In traditional medicine, the healing properties of nettle, with uterine bleeding, are used as well as in folk medicine. The properties of nettle help stop the blood because it contains a number of:

organic acids;
vitamins K, C, A, B;
phytoncides;
esculin;
glycosides;
tannin.

You can buy a ready-made nettle extract at the pharmacy and take it daily three times a day, 20-35 drops in a tablespoon of water, this will normalize the menstrual cycle.

To prepare nettle broth, do the following: 1 tablespoon of raw materials is poured with a glass of boiling water and simmered over low heat for several minutes. Next, cool, filter. It is taken orally before meals, 2 tablespoons three to five times a day.

Nettle is contraindicated for:

hypertension;
kidney disease;
thrombophlebitis.

Popular folk recipes

I cite as an example a list of folk recipes with which in the past folk healers pacified or stopped bleeding.

Clear peel from six oranges... Put the peel in a saucepan with one and a half liters of water. Then put on fire and boil until the entire volume is boiled down to half a liter. It is taken orally one fourth of a glass three times a day.
One tablespoon yarrow simmer slowly over the fire in one glass of water for about ten minutes. Drink a decoction of one third of a glass three times a day before meals.
Take one teaspoon horsetail, pour a glass of boiling water into a jar, insist for 2 hours, wrapping it up. Strain and take orally 1 tablespoon three times a day.
Dry grape leaves ground into powder. It is taken orally 4 times a day, 1 tablespoon of powder.
Three tablespoons clover pour a glass of boiling water and leave for 2 hours, wrapped. Drink like tea.
2 tablespoons raspberry leaf pour one glass of boiling water, insist for 2 hours, wrapping it. Take half a glass four times a day.
Take 1 tablespoon St. John's wort and pour 1 glass of boiling water, wrap it up, insist for 2 hours. It is taken orally 3 times a day, one third of a glass.

At home, you can stop uterine bleeding that is not dangerous during menstruation. But stopping heavy bleeding is the task of specialists.

Before choosing any remedy to stop or reduce bleeding - consult your gynecologist!

Bleeding during menstruation is normal

The release of blood during a normal menstrual cycle has its own characteristic features, well known to every girl:

The duration of menstruation ranges from 3 days to 1 week and does not exceed the indicated periods.
Menstruation occurs after a certain period of time (from 21 to 35 days), which is individual for each girl separately.
Menstruation begins with scanty, smearing bleeding. On days 2-3, more profuse bleeding is observed, which fades away by the end of menstruation.
The color of the bloody discharge is scarlet at the beginning, then bright red. At the end of menstruation, the blood becomes dark burgundy or black.
Blood clots with normal menstruation leave, however, in small quantities and mainly on the 1-2 day of menstruation.

Important! It is important for every girl to know the difference between normal menstrual bleeding and pathological bleeding. So you can see your doctor in time if you suspect uterine bleeding.

You also need to know that with normal menstruation, no more than 4 pads are required for one day. In this case, menstruation is considered to be physiological, not abundant.

Pain symptoms are present only at the beginning of menstruation, then the pain and discomfort in the lower abdomen go away. The pains are easily relieved by taking antispasmodic and analgesic drugs, they do not interfere with the performance of familiar, everyday activities.

Pathological uterine bleeding: signs

To distinguish bleeding from menstruation, pay attention to the nature of the bloody discharge, their amount and time of onset. Uterine bleeding is characterized by the following symptoms:

Premature or late onset of "menses".
Profuse bleeding. Up to 10 or more pads are required for one day.
The release of blood lasts more than a week, the volume of blood loss does not decrease.
During menses, a large number of bright red blood clots are released.
Menstruation is accompanied by symptoms of weakness, fatigue. Drowsiness, thirst and dry mouth, increased sweating are noted. The girl, as a rule, complains of intense pain in the lower abdomen of a squeezing or pulling character. The pain syndrome can be so excruciating that it forces you to take a forced position: with your knees brought to your stomach. Pain interferes with daily activities.

How to distinguish between periods and bleeding after childbirth

Postpartum bleeding is a normal physiological process. Normally, a woman still has at least 4 weeks of the postpartum period, there is a release of spotting bloody discharge - lochia. Distinguishing bleeding that has begun from lochia is quite simple:

Bleeding proceeds with profuse blood flow (lochia - scanty).
The color of blood during bleeding is scarlet, bright red (in lochia it is rusty, brown, or colorless).
Lochia are distinguished by a specific unpleasant odor.
Lochia is separated without blood clots.

Bleeding after pregnancy is especially dangerous for a woman's life. It is accompanied by symptoms of general weakness, headaches, low blood pressure. Women complain of pain in the lower abdomen.

Internal bleeding - what is it?

Symptoms of pathology

Common signs of bleeding

Views

Causes

Methods for determining the location of internal damage

How to stop the blood

Drug therapy

When is surgery required

Internal bleeding during pregnancy

Effects

General information

Mechanism of development of DMK

Juvenile DMK

Causes

Diagnostics

Treatment

DMC of the reproductive period

Causes

Diagnostics

Treatment

DMC of the climacteric period

Causes

Diagnostics

Treatment

Prevention of DMK

What types of bleeding are there and why do they occur?

Arterial bleeding

Venous bleeding

Capillary bleeding

Parenchymal bleeding

Video: bleeding in the "School of Doctor Komarovsky"

The main causes of bleeding

What is the risk of bleeding for a person?

Signs of bleeding

General

Local

External outpouring of blood

Manifestations of latent bleeding

Signs of internal bleeding

Can the body cope with bleeding?

First aid

First aid for arterial bleeding

Harness imposition rules

Danger

Video: emergency care for severe bleeding

Venous bleeding

Video: first aid for venous bleeding

Capillary bleeding

Therapy after stopping bleeding in a hospital

Bleeding from the uterus: norm and pathology

Hemorrhages: causes of development

First aid: how to stop uterine bleeding at home

External signs: what it looks like

Subjective symptoms: what he complains about, what he reports

What you need and can do

What not to do

Medication treatment

Folk remedies at home

Highlander pochechuyny

Water pepper

Shepherd's bag

Nettle

Popular folk recipes

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