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- Recovery after childbirth
- Home
- Informtion
- Doctors inform
- Gynecologist informs
- Recovery after childbirth
Recovery after childbirth
In most cases, the restoration of normal well-being is not rapid. The first feeling of incredible relief has passed, and now you notice that your stomach is still big, and even a little sore. In order to return to its previous size, the uterus must continue to contract for a long time and diligently. Its weight decreases from 1 kg to 50 g within 6-8 weeks.
Since contraction of the uterus occurs due to the work of muscles, this is accompanied by pain of varying intensity, reminiscent of mild contractions. You may notice increased pain while breastfeeding your baby. The thing is that stimulation of the nipple causes an increase in the level of oxytocin in the blood, which promotes uterine contractions.
For better contraction of the uterus, it is recommended to lie on your stomach after childbirth. If you feel good, try to move more and do gymnastics.
Another worrying circumstance is pain in the perineum, which appears even if there were no tears and the doctor did not make an incision. This occurs because the tissues were subjected to severe stretching during childbirth. Usually the pain is not very intense and goes away after 2-3 days. But if there were tears or an incision in the perineum, then the pain may last longer - 7-10 days. You should carefully monitor the stitches and perform hygiene after each visit to the toilet. In addition, it is necessary to treat the stitches daily with antiseptic solutions, and you cannot sit for 2 weeks.
After childbirth, hemorrhoids often appear. Good hygiene and a daily evening shower can help reduce pain. Don’t forget about your diet, include in your diet foods that are rich in fiber and have a mild laxative effect: seaweed, beets, baked apples, cauliflower, sprouted grains. Medicines are usually not used because the inflammation goes away in most cases over time. If everything does not go away on its own and the woman continues to suffer from hemorrhoids, you need to see a doctor and use the medications prescribed by him or take a course of physiotherapeutic procedures.
Constipation that occurred during pregnancy may continue to recur in the postpartum period. They are, in particular, caused by the fear of damaging the seams on the perineum. However, such fear is in vain. In addition, during defecation, you can hold the area where the stitches are placed with a napkin, which will reduce tissue stretching, and defecation will be less painful. Stool usually does not occur immediately after childbirth, but after 2-3 days. To prevent constipation, eat prunes and dried apricots, drink mineral water. And only if there was no bowel movement on the 3rd day, you can use a laxative suppository.
After childbirth, particularly strong discharge from the uterus is observed in the first day, then it decreases. After just 3 days, the discharge becomes mucous-bloody. By the 5-6th week after birth, discharge from the uterus stops altogether. During this period, you need to carefully observe hygiene, because an infection that gets into the uterus can lead to endometritis (an inflammatory process of the uterine mucosa).
For 9 months, all organs of the female body worked to ensure the child’s proper development and good health. Now he was born and became completely “independent”. However, the functions of a woman-mother did not end there. The main one - providing the baby with food - is taken on by the mammary glands. Hormonal changes continue in a woman’s body, due to which significant changes occur in the mammary glands, and they begin to produce milk. In the first 2-3 days, colostrum is released, and already on the 3-4th day - transitional milk, which gradually turns into mature breast milk. Feeding your baby stimulates milk production. Therefore, if lactation is insufficient, more frequent breastfeeding is recommended.
However, women often face the opposite problem - excess milk and difficult outflow. This, in turn, leads to stagnation and engorgement of the mammary glands - they harden, increase in volume, and painful sensations appear in the breast area. Your body temperature may even rise. How to prevent such phenomena?
First of all, try to breastfeed your baby regularly, and in the first 3-4 days after birth, limit fluid intake to 800 ml per day. Then the mammary glands will gradually become soft again. In addition, it is important to know that in the first days after childbirth, the skin of the nipples is very delicate and may crack. This makes them vulnerable to infection, the entry of which into the cracks can lead to the development of mastopathy. Therefore, you need to take good care of your nipples and wear a comfortable bra, which will help the proper development of lactation.
To prevent cracks from appearing on the nipples, you need to alternately place the baby on each breast in the first 2-3 days after birth. First, give the baby one for 5-7 minutes, then another for 5-7 minutes. To prevent cracks, there is a special cream that should be used between feedings, and before them, thoroughly wash off its remains.
These are all the troubles that are easily forgotten and seem not so significant against the backdrop of new worries. Now your attention will be constantly occupied by the baby. However, it is very important not to forget about yourself, maintain your health and restore your former beauty. Not everyone succeeds, which contributes to the development of postpartum depression.
Lochiometra
After childbirth, under the influence of cellular enzymes secreted by the granulation shaft, blood clots and fragments of the decidua remaining on the walls of the uterus are liquefied. In addition, leukocytes, erythrocytes, plasma and lymph penetrate into the uterine cavity through the wound surface. All these elements form lochia - postpartum wound secretion, which normally actively flows from the uterine cavity through the cervical canal into the vagina.
The first 2-3 days after birth, lochia is bloody in nature, then, from the 4-5th day, it acquires a dark red and brownish tint, and after a week it becomes yellowish-white due to the high content of leukocytes. From the 10th day, the discharge becomes light, watery, and has a serous-mucous consistency. Gradually, the amount of lochia decreases, and by the end of the 3rd week, the discharge practically stops and soon disappears completely.
When there is a delay in the outflow of postpartum secretions, they speak of a lochiometer - stagnation of lochia in the uterine cavity. The danger of developing lochiometra lies in the high probability of infection of the contents of the uterus, since lymph, serum, blood, and tissue debris serve as the best nutrient medium for the proliferation of microbial flora. Most often, endometritis develops against the background of lochiometra.
Reasons for the development of lochiometra
The development of lochiometra is caused by mechanical obstacles to the outflow of secretions in the cervical canal or insufficient contractility of the uterus.
Mechanical obstacles can be caused by kinks (hyperanteflexion) of the uterus or blockage of the cervical canal by blood clots, remnants of the decidua and exfoliated uterine tissue.
Insufficient contractile activity of the uterus in the postpartum period usually develops as a result of overstretching of the uterus (with a large fetus, polyhydramnios or multiple pregnancies), weak or discoordinated labor, spasm of the internal os, cesarean section.
The development of lochiometra is facilitated by prolonged bed rest and low activity after childbirth.
Symptoms of lochiometra
Lochiometra develops 5-7 days after birth and is characterized by a noticeable decrease or cessation of postpartum discharge from the uterus. In this case, there is an increase in the size of the uterus compared to the norm on the current postpartum day, and its pain on palpation. The general health and objective condition of the woman during the lochiometer does not suffer, the body temperature is normal, there is no tachycardia.
If timely treatment tactics for lochiometra are delayed, fever (body temperature 38-40°C), chills, cramping pain, cloudy discharge with an unpleasant odor, and tachycardia appear. After 1-2 days, the temperature drops critically with the simultaneous appearance of liquid, purulent lochial discharge.
Diagnostic lochiometers
Lochiometra is diagnosed based on characteristic clinical signs. With the help of a gynecological examination, an unevenly enlarged and painful uterus is determined, which has a dense elastic consistency, often - closure of the internal pharynx, and an inflection of the uterus.
Clarifying diagnostics of lochiometers includes ultrasound. during which the expansion of the uterine cavity is revealed, the presence of hyperechoic blood clots and liquid blood in it.
Treatment lochiometers
Treatment of lochiometra is to ensure the free outflow of lochia, taking into account the cause that caused this condition.
When lochiometra is detected, the gynecologist prescribes injections of antispasmodics (papaverine, no-shpa) to relieve spasm of the uterine pharynx. In the treatment of lochiometra, uterotonic (uterine contraction) agents are used - oxytocin, methylergometrine. For free outflow of secretions, it is recommended that the postpartum woman lie on her stomach 2-3 times a day for 1-2 hours.
With hyperanteflexia of the uterus, the bend is eliminated during a bimanual examination; physical therapy is prescribed. In the case of lochiometra, caused by blockage of the cervical canal with clots, during examination on the chair, the cervical canal is manually expanded and the clots are carefully removed.
Clinical gynecology considers situations where lochiometra does not resolve within 2-3 days as an indication for instrumental removal of the contents of the uterus with a curette or vacuum apparatus under the control of hysteroscopy. For the prevention and treatment of postpartum infections against the background of lochiometra, antibiotics are prescribed taking into account the results of a bacteriological smear.
Complications of lochiometers
If, after the elimination of lochiometra, uterine pain, poor contraction, and hyperthermia persist, one should think about the development of postpartum metroendometritis.
If the infection progresses, the condition of the postpartum mother may worsen due to the development of purulent-resorptive fever, manifested by intoxication, abdominal pain, purulent discharge with a putrid odor. Against this background, the transition of lochiometra to pyometra is noted.
Prevention and prognosis with lochiometer
To prevent the development of lochiometra, competent management of pregnancy and preparation of the woman for childbirth is required, as well as careful monitoring of the postpartum woman during the postpartum period: regular monitoring of uterine contractions (daily palpation determination of its sensitivity, consistency, fundal height), volume and nature of discharge.
In the postpartum period, a woman needs to monitor the timeliness of emptying the bladder and intestines, breastfeed the newborn upon request, perform postpartum exercises, and lie on her stomach.
After discharge from the maternity hospital, the young mother should also monitor her well-being and discharge from the genital tract. In case of fever, retention of lochia, changes in their character or smell, immediate contact with a gynecologist is necessary.
The prognosis for timely detection and elimination of lochiometra is favorable.