Duration of discharge after caesarean section. Yellow discharge after childbirth: normal or cause for concern

Discharge after caesarean section will be required. Postpartum discharge - lochia - does not stop throughout the entire period of recovery of the uterus.

What are the discharge after caesarean section

After childbirth, the uterus is damaged and takes some time to heal. Surgical childbirth significantly prolongs the rehabilitation time compared to natural. In the postpartum period, women are allocated lochia, which consist of:

• blood;
• dead particles of the mucous membrane of the genital organs;
• mucus from the cervical canal.

Over time, bleeding stops, the volume of lochia decreases, they become thicker. The color of the discharge gradually changes because the wound surface is tightened. Lochia change color in stages:

• bright red;
• red;
• bloody-serous;
• red-brown;
• dark brown;
• brown;
• light brown;
• yellow;
• yellowish white;
• serosanguineous;
• colorless.

If the discharge contains pus, green clots, remains bright red for too long, you should immediately consult a doctor.

Yellow discharge after caesarean section

There is more and more mucus in these lochia, but sometimes streaks of blood may appear. The yellow hue is associated with a large number of leukocytes in the secretions. Leukocytes - white blood cells - protect a person from infections. female body during the recovery period is weakened, the protective environment of the genital organs is not restored, so additional measures against infection are necessary.

Allocations are becoming poorer, "smearing", serosanguineous and, finally, colorless. This means that the lochia has stopped, and reproductive system women recovered after childbirth. In operated puerperas, this moment comes later, because. their muscle fibers are so damaged that they prevent the uterus from recovering faster.

Bleeding after caesarean section

At first, the lochia is bright red in color with clots, because they have a lot of red blood cells. In fact, at this time, the most intense blood loss occurs, a woman's hemoglobin drops sharply. Gradually, the color turns into bloody-serous. This means that there are fewer red blood cells, plasma, serum and leukocytes ooze from the healing walls of the organ. Then the color will darken, become red-brown, brown.

Some women are surprised that after surgery from the vagina there is blood, because the seam is on the stomach. They do not take into account that the wall of the uterus was also cut, and when the child was removed, the mucous membranes of the organ were damaged. The uterine scar prolongs lochia by an average of 20 days (compared to women who gave birth naturally). Surgical intervention significantly complicates the process of uterine contraction, which short period should restore its previous dimensions, having decreased by almost 20 times.

Mucous discharge after caesarean section

Colorless transparent mucus comes out of the cervical canal. These are ordinary discharges, the so-called, which appear daily in each healthy woman. The cells of the mucous membranes of the genital organs are constantly updated, dead particles of the epithelium are excreted with the help of a mucous secretion. Normally, there may not be any discharge at all, they may be whitish.

At the moment when the lochia lose their color, the postpartum period is over, the uterine mucosa has regenerated, and the puerperal can completely surrender to the role of the mother.

Brown discharge after caesarean section

Lochia becomes brown when the volume of secretions decreases significantly. The color then begins to lighten to light brown and yellow.

To get rid of secretions as soon as possible, you need to move a lot and monitor regular bowel cleansing, which sometimes has to be stimulated. glycerin suppositories or enemas.

How long is the discharge after a caesarean section?

The maximum duration is 56 days. When discharged from the maternity hospital, the doctor on duty conducts an examination on a gynecological chair, takes a smear for the microflora, and conducts a conversation. It is better to think over the questions in advance, the answers to which excite. The main one should be: “When to start worrying about prolonged bleeding?”.

Sometimes a few days after the cessation of spotting, bleeding resumes. This may begin menstruation, which for the first time after childbirth takes longer than a woman is used to. Another reason for "intermittent" lochia may be that the contractility of the uterus is impaired.

If the woman in labor feels great, but the discharge does not stop in any way, it is better to seek the advice of a doctor. The check will not take much time, but it will be possible to avoid hospitalization in case of complications. Better to contact women's consultation in a timely manner.

Women with prolonged bleeding after a caesarean section are taken immediately, without waiting, even if she feels well. More often this is done by the doctor on duty in a separate office. First, an examination is carried out on a chair, then an ultrasound is done (immediately, out of turn). If the results of the examinations are satisfactory, hemostatic agents, antispasmodics are prescribed. For example, an infusion of water pepper and No-shpa.

The uterus takes on its former size much faster in those women in labor who often put babies to their breasts, lie on their stomachs, and also move a lot. During feeding, a woman feels that the uterus begins to contract more intensely. Allocations at this moment are amplified. They are also stimulated by walks and small physical activities. The cessation of secretions is a sign of involution, i.e. full recovery uterus.

When should you worry?

• After 8 weeks of continuous bleeding.
• If the amount of discharge has changed dramatically. When the bleeding intensifies so much that no hygiene products can save, or, conversely, it stops abruptly (lochiometer - delay, accumulation of lochia in the uterus), you need to sound the alarm. If the contractility of the uterus is reduced, it must be stimulated. Sometimes doctors recommend taking No-shpu for several days in case of sudden disappearance of lochia. This drug reopens the cervix, which closed prematurely, blocking the flow of secretions. They are locked inside, accumulate, which leads to internal inflammation.
• With daily increasing pain in the lower abdomen.
• With the occurrence of itching in the genital area. This is a symptom of thrush - vaginal candidiasis.
• High temperature, low blood pressure, increased heart rate, cold skin are clear signs of an inflammatory process. By the way, we must not forget that during lactation it is better to measure the temperature in the bend of the elbow.

Possible causes of unpleasant symptoms:

• Unprofessionally performed surgery (for example, leaving parts of the uterus in the uterus amniotic sac or placenta). If after the birth there are some extraneous pieces left inside that even an ultrasound scan did not find before being discharged from the hospital, then they will begin to decompose, and the inflammatory process will begin. Antibiotics will not help a woman in this situation, these particles (or a tampon forgotten by surgeons) will have to be removed. In the "best" case, a "cleansing" of the uterus is carried out, in the worst - a second operation.
• The inability of the body to recover on its own after childbirth (for example, poor contractility).
• Curvature of the uterus.
• Spasm of the neck.
• Infection.

It is important to take timely measures and stop the development of complications after surgery. Otherwise, a young mother runs the risk of being hospitalized for a long time, leaving her newborn baby at home.

Care after caesarean section

In addition to mandatory hygiene procedures make dressings daily. You can not douche and take a bath, so as not to infect the infection. For a while, the seam cannot be wetted. Rubbing with a damp terry towel can help out.

The rule should also remain special gymnastics, which strengthens the muscles of the abdominal press, which they begin to do back in maternity hospital. It is recommended to perform exercises after each feeding, ending with the most difficult one, when you need to lie on your stomach for some time.

You can not immediately abandon the postpartum bandage. It is necessary for the wound to heal faster, because the “sagging” stomach stretches the skin and prevents the edges of the wound from quickly growing together.

If during dressing it was noticed that the seam began to diverge, classes should be stopped. Signs of inflammation, "swelling" of the seam should also cause concern. You need to immediately contact the gynecologist so that he prescribes new drugs for dressings. Usually, in addition to the seam, Levomekol ointment is applied in a thick layer. The main thing is to immediately apply for medical care, otherwise you can get into the operating room again.

The cessation of discharge indicates that it is possible to resume intimate relationships, and pathological changes in the area of ​​the uterus was avoided. And when the baby is 2 months old, you can pamper yourself by taking a bath.

Now some pregnant women seriously believe that a caesarean section is best method childbearing and insist on an operation. If there are no indications for surgical intervention, then it is unreasonable to require it. For a healthy woman in labor, an operation will never be better than natural childbirth. Any operated mother will confirm this.

In recent years, the number of contraindications to natural childbirth increased greatly. If natural delivery turns out to be unsafe for mother and child, the gynecologist decides on a caesarean section - an operation that has facilitated childbirth for millions of patients. However, after surgical intervention long rehabilitation period, during which the likelihood of complications in the form of pathological uterine discharge is high.

What discharge is considered normal - red, yellow, brown or white? How long do lochia go? How long can bleeding last after surgery? What to do if there is constant bleeding after a cesarean?

Why is there discharge after caesarean section?

During pregnancy, the uterus undergoes the greatest changes. By the 9th month, it increases almost 500 times, and after the birth of the baby, a continuous wound surface forms inside it. Recovery involves wound healing, the formation of new epithelium, and many other processes. The first stage is the discharge of uterine lochia. This process occurs both in natural childbirth and in caesarean section.

The two main differences are the length of the recovery period and the increased risk of infection, since the uterine cavity is opened during surgical delivery. Uterine discharge changes color and consistency depending on the stage of healing and the condition of the woman in labor. When the discharge ends, a woman must definitely see a gynecologist.

What should be the normal discharge?

Lochia are first red, then brown, and at the last stage they become mucous. In order to support normal condition and prevent the development of complications in the form of changes in the color, frequency and volume of lochia, obstetricians give patients the following recommendations:

• carefully monitor hygiene;
• give preference to the position lying on the stomach during sleep;
• leave a cold heating pad on the stomach for 3-5 minutes;
• wear a bandage;
• take care of the chair
• avoid stagnation of urine or feces;
• avoid sexual intercourse.

Color, smell, texture

Discharge after caesarean section differs in basic parameters, such as color, smell and consistency, on different weeks. After surgery, the presence of clots is not alarm signal. They only say that the uterus is self-cleaning, their absence, on the contrary, should alert. Doctors recommend focusing on the following normal indicators regarding discharge after cesarean:

• In the 1st week. For 7 days after the caesarean section, the patient has a rich red discharge. Mucus is also present in the lochia, which is not present after a normal delivery. They also contain clots - particles of the placenta.
• In the second week. During this period, they become dark, almost brown, and also acquire the smell of iron. The clots disappear.
• After the first month. The discharge darkens even more, becoming almost black with an iron smell.
• Two months later. The volume of secretions decreases, they become mucous, transparent or yellow.

Duration and intensity

Many women in labor are interested in how many days the discharge goes. Uterine lochia after childbirth without surgical intervention lasts less in time. After a caesarean section, they can be released for 2.5 months. At first, the volume of secretions reaches 300 ml per day, gradually decreasing. A mobile lifestyle, frequent attachment of a newborn to the breast affect the amount of discharge. With its increase or heavy bleeding 10-20 days after caesarean section, the patient should see a specialist.

Pathological discharge

Due to the nature of the operation and the large wound surface, the risk of bleeding and other complications increases. Operative delivery provokes a violation of the release of the hormone oxytocin, one of the functions of which is to reduce the uterus to prenatal size.

The first alarming sign of pathology is prolonged discharge. Normally, they should not go more than 8-10 weeks. At purulent processes their color and smell also change. You will need to see a gynecologist in the following circumstances:

• Lochia with blood depart more than 14 days. lingering bleeding- the first sign of inflammation in the uterus.
• Isolation of blood lasts less than three days. Bloody discharge lasting less than three days or intermittently gives reason to suspect that the uterus is weakly contracting, as a result of which the need for drug acceleration of the process increases.

Green, purulent, with an unpleasant odor

If in one day the lochia turned green with an unpleasant, fetid odor, you should not hesitate, you should see a specialist as soon as possible. Such characteristics of them signal an inflammatory pathology in the endometrium of the uterus - endometritis. Additional symptoms endometritis:

• high temperature indicators;
• drawing pains in the lower abdomen;
• general weakness;
• nausea.

Green discharge may indicate infectious diseases in the uterus, vulva, fallopian tubes Oh. These include:

• Bacterial vaginosis. Thick green discharge is accompanied by itching and redness of the labia.
• Chlamydia and gonorrhea. The volume of secretions does not change, but there is pain during urination and sharp pain lower abdomen.
• Colpitis. This is an inflammation of the vulvar mucosa, accompanied by itching, burning, purulent discharge mixed with blood.

Treatment of such diseases is carried out on an outpatient basis. The patient is prescribed antibiotics, vitamins, and then - bacterial preparations to restore normal microflora.

Watery discharge

Lochia that have changed their consistency indicate the release of liquid transudate from the lymphatic vessels. If a specific “fishy” smell is added to the transparent watery discharge, this means that the patient is sick with gardnerellosis (vaginal dysbacteriosis).

Regardless of the course of labor, it is necessary to monitor the nature of the uterine discharge. Any unreasonable manifestation may be a symptom of a serious illness, the treatment of which is not always carried out on an outpatient basis.

Ended too soon or does not stop for a long time

In some patients, discharge after caesarean section stops ahead of schedule. medical practice there are cases when in women in labor after surgical delivery, the discharge ended and started again.

Normally, lochia disappears completely only after 4-5 weeks. The termination of allocations earlier than the above period, of course, should alert. It can be a manifestation of the bend of the cervix, in which the discharge of secretions is disturbed and stagnation occurs. Patients after abdominal surgery very often face such a problem due to a decrease in uterine contractility. Stagnation in the uterus can provoke the process of decay.

This disorder is treated with massage and oxytocin injections. In order to avoid repeated surgical intervention, the patient must immediately see a gynecologist.

Many after caesarean also face the problem of prolonged discharge. Blood lochia normally ends after 14 days, physiological ones last up to 5–8 weeks. Protracted discharge may indicate endometritis.

Scanty or plentiful

The amount of discharge is one of the main indicators of the recovery of the body after surgical delivery. Too little or too much lochia can also be a sign of serious gynecological pathology. Reasons for their decline include:

• lack of training birth canal before the operation;
• narrowing of the cervix, causing a violation of the outflow of secretions.

If scanty lochia is accompanied by severe arching pains in the uterus, you should immediately consult a specialist. The gynecologist will be able to determine the cause of the pathology and prescribe treatment, taking into account the results of the examination on the chair.

Abundant lochia can also be a sign of a violation of the functionality of the reproductive system. The volume of secretions exceeding 300 ml per day is considered elevated. Reasons for this condition include:

• blood clotting disorder;
• open bleeding from a recently sutured suture;
• violation of the contractility of the uterus;
• remnants of tissue in the uterus, which can provoke suppuration.

A woman should only worry when brown and red discharge continues for more than 2 weeks. All of the above symptoms are usually accompanied by pain that is not characteristic of uterine contractions. In order to receive effective treatment, you need to see a specialist and go through all the necessary diagnostic measures. The examination includes a coagulation test, examination on a chair, a visual assessment of the size of the uterus, and diagnostics of the uterine cavity by ultrasound.

White curds with itching

A white substance on underwear after a cesarean without accompanying manifestations is not a reason for worries or emergency hospitalization. They may appear 2 weeks after birth. Allocations white color having a curdled texture and bad smell, are a symptom of vaginal candidiasis. Problem fungal infection is one of the main among patients who survived abdominal surgery. Postoperative period after surgical delivery requires antibiotic therapy, side effect which becomes the development of thrush.

Diagnosis of vaginal candidiasis includes bakposev or a smear on the microflora from the vagina. Treatment is prescribed in accordance with the results of the study.

Care of the external genitalia after caesarean section

Proper care of the genitals after surgery is the only the right way avoid infection and speed up recovery. Some of the basic rules that mothers need to follow include:

• Regular change of pads. A woman should replace old pads with new ones 3-4 times a day. Preference should be given to postpartum hygiene products with maximum absorption.
• Hygienic treatment of the genitals after a bowel movement. When washing, avoid cosmetics. You need to choose soap without dyes and flavors.
• Frequent change of underwear. A patient who has survived an operative delivery should change her panties after each wash.

In addition to the rules of hygiene, a woman should know some rules that contribute to the rapid discharge of lochia after surgical delivery. Doctors give patients the following advice:

• Emphasis on breastfeeding. It promotes the release of oxytocin into the blood, which affects the frequency and intensity of muscle contractions of the uterus.
• Sleep on the stomach. In this position, the contractility of the uterus is normalized.
• Reception prescribed by the doctor antibacterial drugs. Operative delivery increases the risk of infection, so the benefits antibacterial agents for the mother in this case exceeds the harm to the baby.

Regardless of the process of childbirth - whether the birth occurred naturally, or by the method of abdominal surgical intervention, in without fail postpartum discharge, or lochia, will be observed. And until the accumulated slag is completely washed out of the fallopian tubes, muco-bloody clots will be released from the vagina.

The time period of how long discharge can go after cesarean - purely individual factor. It is directly related to the recovery process inside the uterus. This is practically its twenty-fold decrease, and complete regeneration of tissues. But before the inner epithelial layer of the uterus begins its recovery, it needs to clean the wound surface, reject particles of the placenta and dead epithelium that was not removed during the operation.

The period of discharge of the postpartum secret consists of four stages, gradually replacing each other.

1. Postoperative, lasting about a week. In the normal course of the process, voluminous bright red, burgundy and even scarlet masses containing bloody-mucous clots are observed.
2. 7-8, possibly 10 days after delivery, the second stage begins. It is accompanied by low-volume brownish spotting lochia. Blood clots are not observed, and bloody substances can be present only in the form of small inclusions.
3. The third and longest stage, lasting about 4-5 weeks. The amount of inactive secretions is insignificant, and, nevertheless, they are daily, but slightly “smeared”. The presence of blood streaks is practically absent, and the shade of the rejected substance becomes brownish. A month later, the lochia becomes yellowish. This suggests that a huge number of leukocytes have joined the work to restore the mucosa in order to prevent possible bacterial damage to the young epithelial tissue uterine wall.
4. Appearance clear slime indicates that the internal suture was healed after the operation, and the intrauterine postpartum recovery process was completed.

In total, the period of physiological contraction, including scarring of the internal suture and regeneration of the uterine mucosa, can be from seven to nine weeks. This is exactly the period after cesarean, how long the discharge lasts during normal healing, without deviations or pathologies.

Deviations

Each organism is individual, and the duration of recovery postpartum period each woman sometimes may not coincide with the statistics. According to the average terms of lochia discharge, the period from 7 to 9 weeks is considered the norm.

But if a woman at the sixth week after surgery completely stops the withdrawal of the postpartum secret, or, conversely, at the 10th week, the vaginal exit of the masses still continues, and at the same time there are no changes in the composition, shade, density, or manifestation of an unpleasant odor, then this not considered a cause for concern. But it is still necessary to inform the doctor about such deviations.

Any changes in status or appearance lochia, other than the norm, it is necessary to urgently seek help from a specialist.

Pathologies

• The duration of the first stage exceeds a week.
• Sudden cessation of profuse discharge of lochia.
• The duration of lochia is less than five weeks, as well as their length is more than 10 weeks after cesarean.
• Small amount of released substance.
• Abundant withdrawal of secretion, up to 8 weeks from the moment of childbirth.

Each of the points is fraught with a certain amount of danger. So, it is necessary to control how many go after caesarean section bloody issues and their volume. Small amount may indicate that dead endometrium (according to various reasons) cannot leave the body. The causes of stagnation should be established by the doctor, since the risk of suppuration of the non-rejected substance is high. Prolonged discharge may indicate the onset of endometritis or another infectious process that has affected the abdominal cavity.

A dangerous condition is considered a sudden cessation of secretions, there comes a pause, and after a short break, literally in a few days, lochia is formed again. This picture indicates pathological abnormalities from the recovery process of the uterus.

The nature of lochia, or what should be the discharge after cesarean section

Throughout the postpartum recovery period a number of changes occur in the nature of the released substance. At first, lochia comes off profusely, and looks like bloody clots. This is due to the fact that the entire inner surface of the uterus is a vast open bleeding wound.

The ongoing healing process contributes to characteristic changes, and the lochia acquires a mucus-like appearance with inclusions from dead epithelium and other postpartum slag.

What should be the normal discharge after cesarean

The presence of blood, as well as clots in the lochia for a week, gradually stops in 7-8 days. This is considered the norm. If an admixture of mucus is observed in the masses released from the vagina, this is also considered normal, since mucus is a waste product of the fetus inside the womb.

A month after the operation, the lochia should turn a pinkish color, indicating that the healing process is close to completion, but not yet fully completed. By the end of 7-8 weeks, the color of lochia changes to brownish, and they resemble normal menstrual flow in consistency.

Deviations

Appearing "suddenly", a month after surgical intervention a bright pink shade of substance released from the vagina, may be the result of early intimate relationships when injured thin layer young epithelium.

Pathologies

• Be wary of watery, almost clear discharge.. A similar phenomenon is characteristic of circulatory disorders, when a transudate comes out - a liquid secret of the lymphatic and blood vessels.
• Unpleasant smell of transparent lochia, reeking of rotten fish, indicates that a woman develops gardnerellosis - vaginal dysbacteriosis. This is the most characteristic symptom of the disease.
• The most unpleasant, requiring immediate treatment, are considered purulent discharge . They occur when infectious inflammation mucous, and they have a very unpleasant odor. As a rule, the secreted substance is colored yellowish-greenish, general state depressed and accompanied subfebrile temperature. A woman feels pain in the lower abdomen, which radiates to the perineum when exerted.

Hue

The course of the process of healing and restoration of the uterus can be judged by the shade of the expiring masses as a whole. Immediately after surgery - blood-red lochia. And almost at the end of the recovery period, they begin to acquire brownish hues.

The process of restoring the uterine wall after childbirth ends with a smearing substance, very reminiscent of ordinary menstruation. Only the duration of such "monthly" is about two months, not several days.

yellow vaginal discharge after cesarean testify to many things:

• The poor talk about normal healing pale yellowish discharge with a characteristic secret odor, lasting 14-21 days.
• Also considered normal black painless and short-lived lochia that is expelled immediately after surgery. They are associated with hormonal changes in the blood after childbirth. But if a similar phenomenon is observed after a certain period of time after the operation, it is already considered a deviation from the norm.
• Selection bright yellow lochia, closer to orange color, with an admixture of greenery and an unpleasant putrefactive odor, speaks of initial stage endometritis.
• Abundant yellow slime in the discharge indicates an advanced form of endometritis.
• expelled foul-smelling masses of green color indicate the presence of pus in them. Consequently, an infectious infection occurred, and an inflammatory process began to develop in the uterus. Diagnosis is carried out exclusively by a doctor, and on the basis of clinical picture prescribes treatment.
• Lochia white do not pose a threat, if there are no pathologies - itching and foci of redness in the perineum, as well as curdled discharge with a predominance of sour-musty smell.

Quantity

Another an important factor, indicating the normal healing and restoration of the uterine wall in the postoperative period, is the volume of lochia. Deviations should include both a small and short-term amount of ejected bloody masses, and a plentiful one, lasting more than 8-10 days.

In the first case, there is a threat of clogging of the uterine ducts. This phenomenon may indicate that blood clots have formed in the ducts. Prolonged, abundant lochia, the body signals the impossibility of independently carrying out the recovery process. The cause that led to the pathology can only be established by a doctor.

The presence of any odor other than natural, as well as the manifestation of bright shades of lochia, is often the only symptom, indicating a significant deviation from the norm of the recovery process, and a woman should be very careful about such signals.

Hygiene procedures after cesarean

Throughout the postoperative period associated with the recovery phase, it is very important to take good care of your body:

• daily change the bandage at the site of the seam;
• replace shower procedures with wiping with a damp towel until the seam heals, and only after that you can take a shower;

• necessary regular ablution warm water perineal area, at the same time, you need to carefully wipe the external genitalia every time you visit the toilet room;
• use hygroscopic diapers, not pads, in the first 14 days after caesarean, and change them often;
• at the second stage, when the lochia is no longer so abundant, you can switch to pads, changing them every three, maximum four hours;
• the use of tampons is strictly not recommended, as well as special gels for intimate places containing SLS (sodium lauryl sulfate), or its analogues.

When should you see a doctor

• With a sharp change in the volume of secretions.
• If plentiful bloody discharge continuously observed for more than 8 weeks.
• In the presence of pain syndrome in the lower abdomen, and if the pain progresses every day.
• When itching occurs in the perineum.
• At high rates body temperature, hypotension(low pressure), tachycardia (rapid heartbeat), anemia (cold skin).

Factors to Consider

• For better uterine contraction simply need to wear a postpartum bandage.
• Simple physical exercise in the prone position also contribute to the contraction of the uterine wall.
• Favorably affects the process of recovery of the uterus regular bowel movements and, of course, the bladder.

Video

At the end of pregnancy and childbirth, regardless of which way they occurred - naturally or by caesarean section, the uterus should recover. How the uterus is restored, what processes occur in the body of a woman after an operative birth, and how many days the discharge takes after a cesarean, is discussed in detail in this informational video.

Additional Information

• It is very important to choose proper diet after abdominal surgery. Ask what components must be included in the menu of a woman who gave birth by caesarean.
• Familiarize yourself with a set of exercises and methods, sections.
• Highly important information- what are the sections, and how to avoid the formation of adhesions.
• Find out how soon we will allow, and what needs to be considered in intimate relationships after childbirth.
• For those who lead an active lifestyle, you should clearly know what early exercise stress on the body of a woman who has recently given birth.

Tell us about your experience and feelings after the operation. What else does a woman who has given birth through surgery need to know? What are the main difficulties she faces in the first postoperative days? Can you reveal the secret why caesarean section is not considered by doctors as an alternative to natural childbirth?

Approximately one third of total childbirth is a caesarean section, which for many years has been the single most in a safe way operative delivery. One of important criteria to assess the condition of a woman after this operation, this is how many lochia go after a cesarean section.

Already in the early postpartum period, the uterus begins to actively contract, in order to return to its original size over the next two months. Lochia is postpartum bleeding from the genital tract, as a result of the natural involution of the uterus, resembling heavy menstruation. Lochia is not only blood clots, but also cervical mucus and particles of the endometrium lining the uterine cavity.

How long do lochia go after a caesarean section is normal?

Lochia after surgery lasts a little longer than after simple childbirth. So, if after natural delivery, discharge is observed within 4-6 weeks, then with a cesarean section, lochia can last for 8 weeks (but not more than 56 days).

How long do lochia go after caesarean red and brown?

Discharge after caesarean is not the same, and may differ in color, abundance and consistency. In the first few days after operative delivery, a woman feels severe pulling pains in the lower abdomen, which is accompanied by copious excretion from the genital tract blood clots. Over time, the number of lochia decreases, their color also changes - from bright red to more brownish, and soon they acquire a light brown hue, which falls on average in the second week of the recovery period.

IMPORTANT! During the application of the newborn to the breast, the mother's body produces oxytocin, which increases the contractile activity of the uterus, as a result of which bloody discharge from the genital tract may increase.

How long do light lochia go after cesarean?

Approximately by the end of the second week after the operation, the woman notes that the discharge from the vagina becomes less intense and acquires a yellow-brown tint. Every day, the volume of lochia decreases, and with a successful course, after 6-7 weeks, they are replaced by whitish vaginal discharge - leucorrhoea.

How long do lochia go after caesarean profusely?

The greatest blood loss is observed within 2-3 days after caesarean section, and is up to 1000 ml, while on the first day of the postpartum period about half of this volume is released. The number of lochia after operative delivery for the entire period does not exceed 1500 ml.

IMPORTANT! As a lining during a stay in the walls of the maternity hospital, it is recommended to use not sanitary pads, but disposable diapers for an adequate assessment of the volume of blood loss by the attending physician.

How long do lochia go after cesarean, and what should I pay attention to?

The volume and nature of spotting directly reflects the ability of the uterus to recover, and therefore requires close attention.

If you experience the following symptoms, you should immediately consult a doctor:

• The discharge from the genital tract has become more abundant, the lining must be changed every hour (hypotonia of the uterus, bleeding);
• A few days after the cesarean, the bleeding stopped, and pains appeared in the lower abdomen (the possibility of spasm of the cervical canal, as a result of which all the contents accumulate in its cavity);
• More than a week has passed, and the lochia is still as profuse and bloody (weak contraction of the uterus);
• Lochia acquired a putrid odor or changed color to greenish, gray-brown (layering of infection, development of endometritis);
• Against the background of abundant bloody discharge, severe pain in the uterus, pallor and shortness of breath appeared (risk of divergence of the sutures on the uterus);
• The state of health has sharply worsened: the body temperature has increased, chills have appeared (an infectious process);
• Lochia have cheesy blotches, which is accompanied by burning, itching and redness in the labia and perineum (vaginal dysbiosis with the development of mucosal candidiasis).

It should be remembered that for at least two months after a caesarean section, it is highly recommended not to lift weights, engage in serious sports, or resume sex life. In turn, moderate physical activity in the form of walking, starting from the first day after childbirth, breastfeeding on demand, strict adherence to the rules of personal hygiene significantly reduce the risk of developing terrible complications and reduce the duration of lochia after cesarean section.

Caesarean section is the most gentle method of delivery for a child. However, the operation does not exclude the possibility of developing certain pathological conditions in postoperative period.

In addition, for a uterus with a scar, the processes of involution (return to the prenatal state) proceed with some features than with delivery through the natural birth canal.

During operative delivery, manual separation placenta, in which the vessels of the placental site are exposed. Bloody discharge (lochia) in the first 3-4 days of the postpartum period is associated with the gradual healing (epithelialization) of the wound surface.

The volume of secretions in the first 3 days is about 250-300 ml. This is the most dangerous period.

But nature made defense mechanism. Despite the naked, "gaping" vessels, no infection occurs. This is due to the activation of granulocyte cells, macrophages at the site of the wound surface.

Like a barrier, these cells prevent entry infectious agents. This process is called "formation of a granulation shaft". Due to leukocyte cells, biologically active substances and proteolytic enzymes, the inner surface of the uterus remains sterile.

From the 4th day after the operation, the lochia acquire a lighter character, become serous-hemorrhagic, and become less abundant. They take on a brown tint. They contain significantly fewer erythrocytes than in the first days.

From the 10th day after cesarean, there are light discharges, only single erythrocytes are found in them.

By day 21, the nature of the discharge becomes mucous, transparent.

How long do withdrawals last?

6 weeks after the operation, the discharge becomes the same as before pregnancy. On average, for the whole postpartum period the volume of lochia reaches 400-800 ml (with 80% of the discharge occurring in the first 3-4 days).

Pathological discharge after caesarean section

A change in volume, color, or the appearance of discharge with an odor is important sign in the diagnosis of postoperative complications.

meager discharge

A decrease in the volume of lochia (especially in the early days) can occur for the following reasons:

1. premature narrowing cervical canal leads to a violation of the outflow of secretions from the uterine cavity.
2. Planned caesarean section (lack of preparation of the birth canal, the cervix was completely closed by the time of the operation).
3. Violation of the contractile function of the uterus (there is no emptying of the uterus).
4. Rejection breastfeeding(the process of feeding contributes to the contraction of the muscle fibers of the uterus).

Clinical symptoms:

• poor lochia in the first 3-4 days (less than 100 ml) is an unfavorable diagnostic sign;
• temperature rise is possible;
• pulling (possible even).

Diagnostic methods:

1. Examination on a gynecological chair to assess the patency of the cervical canal of the cervix.

Normally, in the postoperative period, the neck should pass one finger without difficulty. At planned operation there is a high probability of narrowing of the cervical canal and the development of a true hematometer (accumulation of blood in the uterine cavity).

1. Monitor the dynamics of uterine shrinkage (normally, every day the height of the uterine fundus decreases by 2 cm, if the outflow of secretions is disturbed, the process of uterine contraction can be slowed down).
2. Ultrasound (it is necessary to assess the uterine cavity: is there an expansion due to accumulated blood).

Too much discharge

Conditions leading to an increase in the volume of lochia:

• remnants of decidual tissue in the uterine cavity.
• violation of the blood coagulation system.
• bleeding from a failed suture on the uterus after a caesarean section.
• violation of the contractile function of the uterus.

Symptoms:

• the volume of secretions in the first days exceeds 300 ml;
• preservation of the bloody nature of the discharge for a long time (within two weeks);
• pain not related to uterine contractions.

Diagnostics:

• the size of the uterus does not correspond to the day of the postoperative period (the uterus is larger than normal);
• copious discharge;
• violation of the coagulation system in the analysis of the coagulogram;
• ultrasound reveals an expansion of the uterine cavity, clots in the cavity, an inhomogeneous echogenic signal from the suture area;
• the cervical canal is not narrowed, the outflow is not difficult.

Discharge with clots

Reasons for these withdrawals:

• violation of uterine contraction (prolonged accumulation of blood in the uterus leads to the formation of clots);
• failure of the suture on the uterus;
• tissue defect in the area of ​​the postoperative suture.

Clinical picture:

• discharge with blood clots;
• the size of the uterus is larger than it should be;
• constant pulling pains not associated with uterine contractions are possible.

Diagnostics:

1. On palpation of the contours of the uterus, the discrepancy between the height of the fundus of the uterus and the day of the postoperative period is determined.
2. Ultrasound: clots in the uterine cavity, expansion of the cavity, the niche of the scar on the uterus is heterogeneous.

Yellow highlights

Causes:

1. Erased, abortive, mild form course of endometritis.
2. Infection of the postoperative suture.
3. Metroendometritis.
4. The presence of a long anhydrous period (more than 12 hours) before a caesarean section.
5. Pathological blood loss during surgery, or initial anemia.
6. Hematoma in the area of ​​the seam on the uterus.

Symptoms:

• unpleasant smell lochia (sharp);
• pulling pains in the lower abdomen;
• rise in temperature is possible;
• weakness, dizziness.

Diagnostics:

1. The uterus is enlarged.
2. Pulse increase.
3. Drawing pains in the lower abdomen.
4. Inflammatory changes in the blood (leukocytosis, ESR acceleration, shift leukocyte formula to the left).
5. With ultrasound - echo-positive signals in the area of ​​​​the walls of the uterus (corresponding to the imposition of fibrin threads), an inhomogeneous signal in the area of ​​\u200b\u200bthe suture, “niches”, a festering hematoma at the site of the scar are possible.

Purulent discharge

Possible reasons:

• endometritis.
• metroendometritis.
• failure, suppuration of the seam.
• parametritis.
• postoperative adnexitis.
• obstetric peritonitis.
• sepsis.

Clinical manifestations:

• purulent or, with a sharp, unpleasant putrid smell, plentiful;
• an increase in temperature to high numbers (39 and above);
• chills;
• weakness, dizziness;
• increased sweating;
• severe pain in the lower abdomen;
• heart palpitations.

Diagnostic criteria:

1. Sharp pain on palpation of the uterus and appendages.
2. The size of the uterus does not correspond to the period of the postoperative period.
3. Painful traction for the cervix.
4. Displacement of the pelvic organs relative to the midline (with parametritis).
5. Sharp pain in the area of ​​the appendages (with adnexitis).
6. Severe inflammatory changes in the blood.
7. Tension of the abdominal muscles, positive peritoneal symptoms (with peritonitis).

According to ultrasound: the uterus is enlarged, the cavity is expanded, the structure of the myometrium is heterogeneous, "a niche in the scar area", a festering hematoma, or an infiltrate in the small pelvis can be visualized.

Hygiene measures after surgery

Compliance with the rules of hygiene is important condition in the prevention of postoperative complications.

You must adhere to the following rules:

• obligatory washing in the first days up to 2-3 times a day.

Gels must be used intimate hygiene or baby soap. It is advisable to use soap without aromatic additives, fragrances;

• change pads every 2-3 hours in the first days. Use pads with maximum absorbency;

In pharmacies you can buy special postpartum pads, but in their absence, you can use others (the main thing is that they absorb the discharge well).

• change underwear frequently. You can use disposable panties.

Important conditions for the physiological course of the postpartum period are:

• in the early days, put a cold load on the uterus, which contributes to its contraction and emptying of blood clots;
• breastfeeding and milk expression contribute to the release of endogenous oxytocin. This hormone causes contraction of the smooth muscles of the uterus, which also contributes to the normal discharge of lochia;
• prevention of infectious complications after surgery (prescription of antibiotics a wide range actions);
• From day 3, it is recommended to lie on your stomach more often. This position contributes to the deviation of the uterus, alignment of the cervical canal, which contributes to the discharge of lochia.

case from practice

A 28-year-old patient was hospitalized at the 39th week of pregnancy in the birth. house for a planned caesarean section (for placenta previa). During the operation, after the removal of the child and removal of the placenta, the patency of the cervical canal was checked (it freely passes one finger).

In the postoperative period, it was diagnosed: on the 3rd day, extremely scanty bloody discharge, the patient complains of nagging pain, the size of the uterus exceeds normal.

When viewed on a gynecological chair: palpation of the uterus reveals soreness, the uterus is larger than normal, the cervical canal is closed and does not allow a finger to pass through, spasm at the level of the internal os.

Ultrasound: in the uterine cavity blood in a volume of 100 ml.

Diagnosis: hematometra (accumulation of blood in the uterine cavity).

It was decided to restore the patency of the cervical canal with the help of bougienage (expansion) to ensure a normal outflow of secretions.

The further postoperative period proceeded without complications. The patient was discharged on the 9th day in a satisfactory condition.

Operative delivery creates additional risks in the development postpartum complications. The suture on the uterus prevents the full contraction of the uterus, during inflammatory processes, the infection spreads not only in the mucous membrane, but also in all layers of the uterus.

These factors impede the normal outflow of lochia, create favorable conditions for the reproduction of microorganisms. It is for these reasons that it is very important to carefully monitor the discharge in the postoperative period, as well as observe the necessary rules of hygiene.