And whether you know...
Allocations, bleedings after the delivery
September 4, 2012
After the child's birth at all women on an extent of several weeks process of emergence of allocations of generative organs continues. Such allocations will continue till that time while puerperal recovery of a mucous membrane of a uterus lasts. Similar allocations from a genital tract is a normal, natural process. However there are also some features of lochias to which it is necessary to pay attention not to miss the beginning of pathological process.
Features of lochias
After the delivery from a genital tract it is accepted to call allocations lokhiya. Initially in days rather large number of lokhiya is allocated. However there is later a gradual reduction of volume of allocations as the wound surface which appeared on an endometria after from it the placenta separated is healed.
As a part of lokhiya blood cells, plasmas, parts of the dying-off epithelium, and also slime from the channel of a neck of uterus are found.
In view of a gradual wound repair there is also a change of structure of lokhiya over time. Respectively, also color of allocations changes. So, if initially they are bright red, then after a while suckers brighten. To define whether normally there is a process of a wound repair, it is important to watch that character of lokhiya completely corresponded to certain days in a puerperal period. And if in the first few days after the delivery young mother can rely on supervision of doctors as she stays in a maternity home, then further nature of allocations is watched by already woman. If it has certain fears regarding character of lokhiya, it is necessary to address for medical consultation at once. Some serious alarm signals can be suspected, defining quantity and color of lokhiya.
Allocations during the first hours after the delivery
If childbirth proceeds normally, then the first two hours after the end of process the woman stays in the maternity block. At this time allocations have to be plentiful, bloody. Their volume, as a rule, makes about 0,5% of the body weight of the woman. But if the number of allocations exceeds 400 ml, and at the same time just given rise woman notes noticeable changes in own state, then the speech can already go about a certain pathology.
To warn bleeding after the delivery, to the woman make bladder emptying by means of a catheter, and ice is put on a stomach bottom for a certain span. Intravenously to the woman after the delivery administer those drugs which promote more intensive reduction of muscles of a uterus. In this case oxytocin is used or metilegrometrit. In the course of reduction the uterus is capable to block blood vessels in that place where the placenta was attached. Respectively, the woman loses less blood.
Doctors provide careful supervision to the woman during the first hours after the delivery as at this time very dangerous state — hypotonic uterine bleeding can be shown. This state arises owing to disturbances in the course of reduction of a uterus and strong relaxation of muscles of a uterus. Having a rest after the delivery, the woman has to control own state nevertheless. At symptoms of severe bleeding it is necessary to report about it to the doctor at once. Such state especially dangerously to those that the woman does not feel either pain, or the discomfort which appeared suddenly. At the same time bleeding for a short time causes strong weakness, and also dizziness.
During the first hours after the delivery bleeding at women who in the course of childbirth received strong ruptures of patrimonial ways can be also shown. Careful sewing up of such gaps significantly reduces risk of bleeding. Therefore the doctor has to make careful survey of patrimonial ways and if necessary put stitches at once after the child's birth. Suture has to be made highly professionally as at sewing up of a gap the hematoma not up to the end can develop, and as a result in fabrics blood will accumulate. At such situation the doctor opens a hematoma and again takes in a section.
On condition of a normality of the given rise woman approximately in two hours she is transferred to chamber
Allocations in the first days after the delivery
In the first two-three days the woman has to have bloody allocations after the delivery. In the first several days suckers remain plentiful (them about 300 ml in an essence are allocated). The woman is forced to change laying or a diaper each two hours. At the same time the smell of lochias can be rotten, sometimes there are small clots.
Gradually suckers become less plentiful and change color. Their shade already dark red, is sometimes closer to brown. If the woman begins to move actively, allocations amplify. In the first days the doctor will be able to estimate all other features of allocations during a bypass. He surely considers allocations on laying or on a diaper and asks young mother on their character. In particular, it is important to doctor to know about what number of allocations appears at the woman per day.
The number of allocations can sometimes increase while the doctor makes a stomach palpation during survey.
Prevention of bleedings in the first days after the delivery
That at the woman who just gave birth to the kid bleedings were not shown, she needs to adhere to some important recommendations promoting normal process of recovery.
Young mother has to empty a bladder at the first desires to an urination. And in the first day after the delivery, regardless of desire to visit a toilet, it needs to be done once at three o'clock. The matter is that the filled bladder does not allow a uterus to be reduced fully.
Young to mothers has to practice feeding by a breast upon the demand of the kid. When nipples are irritated, there is an emission of hormone of oxytocin promoting intensive reduction of a uterus. During feeding of the newborn the woman can feel pain in the bottom of a stomach, similar to feelings during pains. At the same time allocations become more active.
To recently given rise woman recommend to lie, whenever possible, as much as possible on a stomach. Such pose promotes an intensive exit of allocations from a cavity of the uterus and interferes with bleedings. In view of the tone of belly muscles which worsened during pregnancy the uterus can deviate kzad, and outflow of allocations worsens. Respectively, in situation on a stomach outflow becomes more active.
To strengthen reduction of a uterus and to strengthen vessels, to the woman several times a day put ice on a stomach bottom.
In certain cases it is reasonable to women to appoint intramuscular introduction of oxytocin for two-three days. It stimulates reductions of a uterus. Such measure is necessary for those women who gave birth to the large child or took out polycarpous pregnancy. Respectively, the uterus underwent strong extension. Besides, the drug is administered to the women who endured the complicated childbirth.
Not to miss development of bleeding, the woman has to see a doctor at once as soon as lochias sharply became plentiful.
So-called late puerperal bleedings (those which were shown in two and more hours after the end of childbirth) arise owing to the different reasons.
Sometimes puerperal bleedings develop because of a delay of parts of a placenta. It is possible to find the placenta remains in a uterus when carrying out vaginal examonation or at ultrasonic research. At detection of such parts they are deleted, previously making an intravenous anesthesia.
Less often bleeding develops owing to blood coagulation disturbances which arise in view of different diseases of blood. To correct such bleedings very difficult. Therefore the doctor has to obtain information on existence of such diseases at the patient long before childbirth.
Hypotonic bleeding is an effect of too slow reduction of uterine muscles. Such bleeding usually happens plentiful, painless. This state can be eliminated by means of introduction of the reducing means. And for recovery of a loss of blood liquid or blood preparations intravenously is found.
One more possible complication of normal process of recovery – complete cessation of emergence of lokhiya ahead of time. At the same time lokhiya will accumulate in a cavity of the uterus. Such state is called a lohia serosa and is shown as an effect of too severe stretching of a uterus and existence of a bend of a kzada. Against at the wrong time the liquidated lohia serosa the endometritis sometimes develops. The matter is that disease-producing microbes actively develop on so medium as lochias. At similar pathology oxytocin is also appointed, but before its introduction it is necessary to enter Nospanum for a spasmolysis.
Allocations in the first weeks after the delivery
If the recovery period after the birth of the kid proceeds normally, then allocations after the delivery continue about 6-8 weeks. For this period from 500 to 1500 ml of allocations are allocated.
For the first puerperal week emergence of allocations which remind periods is characteristic. But they contain more clots and in general are more plentiful. Every day the woman celebrates reduction of quantity of lokhiya. Their color gradually changes on whitish-yellow, but sometimes pink allocations still appear.
On the fourth week of the period of recovery of allocation become scantier and take the smeared shape. Later, approximately on the sixth week, gradually lokhiya stop, and allocations become same, as well as during the period before pregnancy.
Young mothers who feed the child with breast milk, note faster termination of allocations in view of the accelerated process of reduction of a uterus. Those women who transferred Cesarean section are recovered more slowly as the uterus on which there is a seam is reduced less intensively.
But the most important – to show consideration for own state very much and not to be engaged in independent treatment at emergence of the problems described above.
Correct approach to puerperal hygiene
Not to allow emergence of infectious complications, the woman has to follow all rules of hygiene very carefully. It is important to provide normal outflow of lokhiya from a cavity of the uterus as the disease-producing microflora can actively develop in them that is fraught with development of an inflammation.
Until lokhiya do not stop completely, young mother has to use puerperal laying or diapers constantly. It is necessary to change laying each three hours in order to avoid reproduction of microorganisms for them. In puerperal weeks it is better for women not to use the flavored laying as they increase risk of development of allergic reactions. It is impossible to apply also tampons, they will create an obstacle for an exit of allocations from a vagina. If the woman stays in lying situation, it is possible just to use a diaper for a podkladyvaniye on a surface.
Young mother has to be washed away every time after a campaign in a toilet. Baths do not need to be taken, and here the daily shower is obligatory. At the same time generative organs are washed only outside. Also syringing is forbidden.
It is desirable to observe also other recommendations that allocations after the delivery were normal and stopped in time. The woman should not subject herself to very heavy exercise stresses as it provokes strengthening of allocations.
There are some signs at which it is desirable to address for medical consultation at once. It needs to be made if allocations have very unpleasant smell and at the same time are similar to purulent discharges. A similar sign – the evidence of development of an infection in a uterus (endometritis). At this disease temperature also increases, the abdominal pain is noted.
It is necessary to see a doctor at sharp emergence of bloody allocations after lokhiya already became more colourless and not plentiful. Perhaps, it is necessary to purge a uterus from the afterbirth remains.
If the woman has allocations of curdled type, then, perhaps, she is ill the milkwoman. Especially often the milkwoman is shown after treatment by antibiotics.
Negative sign is the sharp termination of allocations. The similar phenomenon occurs more often at women who transferred Cesarean section.
Sometimes elimination of such complications requires treatment in a hospital.
Recovery of periods
The monthly cycle at each woman is recovered in an individual order. The active puerperal producing hormone of prolactin which promotes production of milk also influences suppression of formation of hormones in ovaries. The ovulation at the same time does not occur.
On condition of breastfeeding of periods are recovered at the woman approximately in half a year after the delivery. If the kid eats artificial mixes, then the menstrual cycle will be recovered on the second or third month after the delivery.
Section: Childbirth and puerperal period