4 weeks postpartum with extreme bleeding and large clots

I am four weeks postpartum after my twins were stillborn at 19 weeks. Last night I had extremely heavy bleeding (soaked through 3 super maxipads in an hour) and passed multiple clots ranging in size from small up to the size of a baseball. I went to the ER and they did nothing but give me fluids and sent me home. When I was at the hospital my blood pressure was 102/63 and my pulse was 117. The bleeding has slowed down but I am very worried because this does not seem normal to me or my mom. Any opinions on what might be causing this would be greatly appreciated.

[Elaine Brown, MD]

Hi!
I'm so sorry to hear that you lost your twins!
I am glad to hear that you went to the ER. I hope by now you have also had follow up with your own doctor.  If you were my patient, I would do an ultrasound to rule out retained placental tissue within the uterus.  If there is any retained tissue, you will need a D&C to clean it out.  Other times there is a condition called subinvolution of the placental site (basically, a "scab" falls off the wall of the uterus where the placenta was attached) which can cause heavy bleeding, but can be treated with medications alone.
You will definitely need a visit with your delivering provider to help sort this out so it doesn't happen again!
Good luck!
Dr B