Discharge one month after caesarean. How long does the discharge last after a cesarean section and what does it depend on? When to contact a doctor

AT last years the number of contraindications to natural childbirth has greatly increased. If natural delivery is unsafe for mother and child, the gynecologist decides on a caesarean section - an operation that has facilitated childbirth for millions of patients. However, after surgery, there is a 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 maintain a normal state 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 differ in basic parameters, such as color, smell and consistency, in different weeks. After the operation, the presence of clots is not an alarm. 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. When it is increased 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 of 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. 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 time. In medical practice, there are cases when women in labor after surgical delivery of 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. If there is too little or too much lochia, this can also be a sign of a serious gynecological pathology. Reasons for their decline include:

• lack of preparation of the birth canal before surgery;
• 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. To receive you need to 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 means of 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 delivery. Allocations white color, having a curdled consistency and an unpleasant odor, are a symptom of vaginal candidiasis. The problem of 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 sure way to 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 of antibacterial agents for the mother in this case exceed the harm to the baby.

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

What should be the discharge after cesarean: a little physiology

During operative delivery, the placenta is manually separated, 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 has created a 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 the entry of 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 of the 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:

• meager lochia in the first 3-4 days (less than 100 ml) is an unfavorable diagnostic sign;
• temperature rise is possible;
• pulling (even arching pains in the lower abdomen are possible).

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. With a 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 bloody discharge long time(in two weeks);
• pain not related to uterine contractions.

Diagnostics:

• the size of the uterus does not correspond to the day postoperative period(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

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:

• yellow or yellow-brown discharge;
• 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 green discharge, with a sharp, unpleasant putrid odor, profuse;
• an increase in temperature to high numbers (39 and above);
• chills;
• weakness, dizziness;
• increased sweating;
• severe pain in the lower abdomen;
• cardiopalmus.

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 an 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.

It is necessary to use gels for 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 if they are not available, you can use others (the main thing is that they absorb 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 broad-spectrum antibiotics);
• 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 poor bloody issues, the patient complains of pulling pains, 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 using 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 of postpartum complications. The suture on the uterus prevents the full contraction of the uterus, with 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 closely monitor the discharge in the postoperative period, as well as observe the necessary rules of hygiene.

• Distinctive features
• Timing
• Lochia character
• Hue
• Quantity

Regardless of how the birth occurred (through surgery or naturally), the inner lining (lining) of the uterus needs a recovery period. It takes about 5-9 weeks if everything goes without complications.

Of particular note are the discharge after cesarean from the genital tract. They are usually called lochia in gynecology. They include blood cells, plasma, mucus, dead epithelium. For many women, they are perceived as a kind of menstruation. However, their color palette, smell, composition, volume change during the postpartum period and signal whether the young mother has everything in order with her body.

Distinctive features

Any operation, like the birth itself, is a serious stress for the body that is tired after pregnancy. Therefore, a woman needs to listen to him sensitively, feel the slightest deviations and know what the discharge after a cesarean section should be and what is considered the norm. This will allow her to notice alarming signals in a timely manner and be treated if necessary. Many sources indicate that lochia after CS is no different from those that come after natural childbirth. In fact, this is far from the case. Differences still exist.

1. The wound surface is much more extensive after cesarean, so the risk of infection or inflammation of the genital organs is very high. So during the discharge after the operation, you need to carefully carry out all the prescribed hygiene procedures And not just once a day.
2. At the very beginning, just after cesarean, about 5-7 days, the discharge is not only bloody in nature, but also contains a lot of mucus, which is not observed after natural delivery.
3. The normal color of discharge after a cesarean section for several days is bright red, rich scarlet, and it is much juicier than with natural process childbirth.
4. The contraction of the uterus and its healing after cesarean is a longer and more protracted process, so the duration of the discharge is also different and is 1-2 weeks longer.

These differences should not frighten and disturb a young, perhaps not yet experienced mother in such matters, since this is the norm of discharge after a cesarean, which indicates that everything is in order. But in order to see something was wrong in time, you need to know about deviations, with which you will first have to contact specialists. Usually they differ little from problematic lochia after natural childbirth.

Timing

One of the most exciting questions is how long the discharge after a cesarean section lasts, in order to know for sure whether the recovery period has dragged on or the process is going within the allowed limits. Information about the deadlines that fit into the norm will allow you to control the current menstrual cycle which should improve soon.

Norm

The discharge rate after caesarean section is from 7 to 9 weeks. So discharge 2 months after cesarean does not pose any danger to the health of a young mother.

Deviations

If after caesarean delivery ended too quickly (within 6 weeks) or too long (up to 10 weeks), this is not a reason to panic. Yes, the limits of the norm are no longer observed, but these indicators can be determined only by the individual characteristics of the organism. If at the same time the composition, smell, density, color, number of lochia do not indicate complications, you should not worry. Although even in this situation, it will not hurt to inform the doctor about this.

Pathologies

A visit to the doctor is mandatory if the duration of discharge in the postpartum period after cesarean has gone beyond the norm. This is either too fast an end (less than 5 weeks), or too long a process (over 10 weeks). Both are equally dangerous. In the first case, the remnants of the dead endometrium, for some reason, could not come out and there is a high probability of their suppuration. With too long lochia, endometritis or an infectious process in abdominal cavity or genitals. The condition is also dangerous when the discharge after cesarean ended and started again: this also indicates some deviations in the process of restoring the uterus.

Knowing how much discharge goes after a caesarean section with a normal healing process, a woman may not worry that this period has been very long for her or, on the contrary, has passed too quickly. After all, in both cases, you will have to take appropriate measures: go to the doctor, undergo additional examinations and, if diseases or complications are detected, undergo a course of treatment, no matter how much you want it.

be careful. You should not rejoice if your discharge has already stopped a month after cesarean. Such a rapid process very often ends in inflammation or infection, which require surgical cleaning of the uterus.

Lochia character

Throughout recovery period after the operation, the nature of the lochia will change. Initially, blood clots will depart, since the uterus at this time is a vast, open, bleeding wound. But over time, in the process of healing, they will change into mucus, dead epithelial cells and other postpartum debris.

This also needs to be monitored very carefully. If, for example, bloody discharge after cesarean does not end in any way, this will be an alarming signal that damaged tissues cannot be regenerated for some reason. Such cases require medical intervention and treatment. Therefore, watch the nature of your lochia and their duration.

1. Presence of blood

The presence of blood in the lochia at first should not raise doubts among young mothers: it is the bursting of blood vessels and damaged tissues that heal. However, here important point are precisely the timing of how many days bloody discharge occurs after a cesarean: if more than 7-8, then this is already abnormal and you need to sound the alarm.

1. The presence of clots

It is also quite understandable in this period of time: they are cells of already dead endometrium and placenta. Already after 7-8 days they will leave, so that the discharge will become more liquid.

1. Mucous discharge

If mucous secretions have also been added to the bloody ones in the first days after cesarean, this is also the norm: in this way the body is cleansed of the products of intrauterine vital activity of the baby.

1. pink discharge

If pink discharge begins a month after cesarean, it means that the healing process has not yet been completed. Perhaps, under some mechanical influence, the injured tissues were again damaged. Very often this happens if a couple is impatient and, without waiting for the end of the recovery period, they start having sex too early.

1. brown shade

After 6-7 weeks, by their nature, lochia will resemble ordinary brownish menstrual smears: the blood will clot and will no longer be so bright and scarlet.

1. Purulent discharge

The danger after cesarean is purulent discharge, which is the first symptom of the endometrium (inflammation of the uterine mucosa). They are usually yellowish-green in color, smell very bad, and are accompanied by fever (due to infection), pain in the abdomen and perineum.

1. watery lochia

Should alert the young mother and watery lochia, devoid of any shade, almost transparent. So a transudate can come out - a fluid contained in the blood or lymphatic vessels. This is bad, as it indicates a violation of blood circulation in this area. In addition, watery discharge after cesarean with an unpleasant odor reeking of rotten fish is a symptom characteristic of vaginal dysbacteriosis (gardnerellosis).

If you had to give birth by cesarean, you must definitely monitor the nature of the discharge that has begun. It is the impurities in their composition that may indicate a particular disease that will need to be identified and treated. Often, all this threatens again with hospital walls - and this is precisely at the moment when a mother needs her baby so much. It is much easier to prevent the problem and enjoy the unforgettable moments of communication with the baby. In addition to character, the color of the discharge can tell a lot.

Hue

Normally, the color of lochia after cesarean should be red at first, then there are already brown discharges (towards the end). The rest of the color palette should alert the young mother and force her to go to the hospital for an additional examination to find out if everything is in order with her body recovery.

Yellowness

If yellow discharge begins after cesarean, they may indicate the following postpartum processes:

• pale yellow, meager lochia by the end of 2-3 weeks is the norm;
• bright yellow, almost orange discharge with a greenish tint, putrid odor on days 4-6 - a symptom of a pronounced, but just beginning endometritis;
• copious, mucous, yellow discharge after 2 weeks is a sign of an already hidden and, most likely, advanced endometritis.

Endometritis cannot be treated on its own: antibiotic therapy or even surgical intervention.

Greens

It's easy to guess that green discharge that began after cesarean are explained by the presence of pus in them. It indicates the course of an infectious, inflammatory process in the uterus. Only medical examination will help to determine its cause and diagnose the disease.

white lochia

By themselves, without accompanying symptoms, white discharge, which may begin some time after a cesarean, does not pose a threat. But as soon as certain signs appear, you need to be alert. These include:

• itching of the perineum;
• redness in the intimate area;
• if there is a discharge with a sour smell;
• curdled texture.

In such cases, a bacterial culture or vaginal swab is required for accurate diagnosis and appropriate treatment.

Black

If black discharge without odor or pain is observed after cesarean, they should be taken as the norm. They are dictated hormonal changes in the blood after childbirth. A deviation is if they go some time after the operation.

To avoid complications of the recovery period after cesarean section, you need to monitor the color of postpartum discharge. It can suggest the problem that has arisen at the very initial stage. This will facilitate its elimination and will allow you to return to normal very quickly, having undergone the necessary course of treatment.

Quantity

A young mother also needs to pay attention to how many lochias come out of her in order to judge how the body is recovering. If there is little discharge after cesarean, especially in the very first days, this can be an alarm signal that the tubes, uterine ducts are clogged, a blood clot has formed, etc.

The opposite situation is no less dangerous: abundant lochia that does not stop for too long is an alarming signal about the impossibility of a full recovery of the uterus after surgery. In both cases, you need to undergo a special examination and find out what is the reason for such deviations.

Any woman wants postpartum lochia to end as soon as possible and nothing overshadows happy motherhood. However, one should not be too hostile towards them. It is they that can serve as that alarming and sometimes the only signal that not everything is in order with the restoration of the body and that some measures need to be taken to help it. Particularly, discharge after a caesarean section with a smell and an unrealistically bright shade should be alerted. This almost always ends with a course of antibiotic treatment, which is highly undesirable during lactation, or another surgical intervention.

After childbirth, the woman's body begins to adapt to the new conditions under which it tries to return to its original state. During this period, there is a decrease in the size of the uterus, contraction of the vaginal muscles, the production of colostrum, and then breast milk hormonal stabilization. Also in the early postpartum period, a woman develops lochia.

Postpartum lochia- uterine discharge from the vagina, consisting of blood cells, plasma, dead cells and mucus. They help in cleansing the uterine cavity from various substances that were formed in it during the period of bearing a child.

Causes of lochia

Lochia after childbirth is the result of the healing process of the endometrium of the uterus. They include dead epithelial cells, erythrocytes, leukocytes, platelets and blood plasma. In the process of leaving the uterine cavity, the secret of the glands of the cervix and vagina joins the lochia.

Over time, the exposed vessels of the uterine epithelium thrombose, the bleeding from them stops, therefore, the number of formed elements (erythrocytes, leukocytes, platelets) in the lochia decreases. Thus, these secretions have two main functions - regeneration of the endometrium and cleansing of the remnants of the placenta and amniotic bladder.

Lochia duration

• the weight of the fetus (a large child leads to a strong stretching of the uterus, so it takes longer for it to recover);
• volume of amniotic fluid a large number of contributes to greater damage to the endometrium);
• the number of births (with repeated births, the recovery of the uterus is faster);
• the appearance of infection (during the inflammatory process, the duration of lochia increases);
• physiological characteristics of a woman (some women in labor have good blood clotting, so lochia lasts a much shorter period of time);
• type of delivery (during natural childbirth, the discharge does not last as long as with a caesarean section);
• lactation (breastfeeding promotes rapid regeneration of the uterine epithelium).

The duration of lochia after caesarean section is on average one and a half months. Their maximum duration is healthy women must not exceed 60 days.

Attention! If lochia is observed longer than one and a half months after natural childbirth or more than 60 days with a caesarean section, a woman should consult a gynecologist.

Prolonged lochia may be the result of insufficient contractile activity of the uterus or problems in the blood coagulation system. Both pathological conditions need to be corrected with medication.

However, if the lochia ended in 2 weeks or faster, there is a possibility of incomplete cleansing of the uterine cavity. This syndrome can lead to purulent inflammation due to the reproduction of pathogenic flora. Therefore, with the rapid end of the discharge in the postpartum period, a woman needs to consult a specialist.

What do the doctor's say:

Characteristics of normal lochia

Red lochia.

They are observed within 3-5 days after birth. The volume of scarlet abundant uterine discharge in the first 5 hours from the birth of the baby should not exceed 400 milliliters. At this time, the woman is under the supervision of a doctor. 5-8 hours after the birth of the child, the late postpartum period begins. During it, lochia are plentiful, have a bright red hue, have a specific "rotten" smell, they contain a large number of red blood cells and blood plasma. These uterine discharges are observed for another 3-4 days, they give the woman in labor a certain discomfort due to their abundance.

Serous lochia.

Usually they are allocated from 5 to 12 days from the moment of birth. Serous lochia change their color from scarlet to brown or brown. The volume of secretions is noticeably reduced, they cease to cause severe inconvenience. Lochia is dominated by immune cells- leukocytes. Serous uterine discharge does not have a strong odor.

White lochia.

Allocations after 10-14 days from the moment the child is born are noticeably reduced in quantity, the woman almost does not notice them. Lochia in this period become more transparent, have a whitish or slightly yellow tint, and are not accompanied by a smell. Gradually, the uterine discharge begins to “smear”, and then completely disappear.

Differences between lochia and menstruation after childbirth

Menstruation lasts about 7 days, while lochia can be observed for up to two months. Menstrual bleeding is always red or brown and may be accompanied by clots. Initially, the lochia are scarlet, but over time they become brown, pinkish, then whitish.

During lochia, the uterus decreases in size due to its contractile function; upon examination, the doctor sees a narrowing of her neck. With menstrual bleeding, the organ swells and swells, and the cervical canal expands.

Also, these selections are different in time of appearance. Lochia begins immediately after childbirth, menstrual bleeding occurs at the moment when the hubbub of "breastfeeding" - prolactin - falls in the blood.

The secretion of prolactin is a natural contraceptive in the postpartum period. The hormone promotes milk synthesis and blocking ovulation. As soon as a mother stops breastfeeding her baby, the amount of prolactin in the blood decreases. This leads to the resumption of the cycle and the appearance menstrual bleeding. If a woman for some reason does not start breastfeeding, menstruation begins immediately after the cessation of lochia.

Pathological lochia

Lochiometer - a pathology in which uterine discharge in the postpartum period stops within 1-2 weeks. This disease occurs due to a violation of the contractile activity of the uterus or the appearance of an obstruction in the path of the outflow of lochia. Its main symptom, in addition to the absence of discharge, is pain in the lower abdomen. The danger of the lochiometer lies in the fact that in pathology there is no cleaning of the uterine cavity, as a result of which inflammation can begin in it.

Bleeding occurs due to the presence of pathologies of the blood coagulation system, violations of the contractile activity of the uterus, the appearance of neoplasms. Against the background of this syndrome, a lack of hemoglobin develops, suffer internal organs especially the brain.

Endometritis - inflammatory disease internal uterine epithelium. With this pathology, lochia becomes purulent, their number can increase dramatically. Endometritis is accompanied common symptoms intoxication: fever, weakness, sweating. Also, with the disease, pain in the lower abdomen and discomfort in the vulva can be observed.

It is a common disease of the postpartum period due to a decrease in immunity. With candidiasis, lochia becomes plentiful and looks like cottage cheese. Quite often, a fungal disease is accompanied by itching in the vulva and pain during urination.

Parametritis is an infectious inflammation of the periuterine tissue, caused by pathogenic microorganisms. This disease is acute, the woman notes the appearance of fever, weakness, abdominal pain, increased sweating, dizziness. Lochia with parametritis increase in volume, they can be observed blood clots and pus.

If the nature of the lochia changes, they stop quickly, or vice versa, a sufficiently long course, you should consult a doctor.

Every woman who has recently become a mother is interested in how much blood flows after a cesarean section. And not in vain, because by the duration of postpartum hemorrhage, its color and quantity, an experienced doctor can judge the general postpartum condition of the woman in labor.

A caesarean section is a surgical procedure in which the baby is taken out through an incision in the uterus, followed by removal of the placenta. It should be noted that such an operation is, first of all, a generic process, the result of which are lochia - postpartum discharge. Very often, women in labor compare them with intense menstruation.

The first 2-3 days after the birth of the crumbs by caesarean section, postpartum bleeding resembles red menstruation with clots, but more intense than usual. In this case, the number of lochia reaches up to 500 ml per day. After 5-7 days, such bleeding acquires an average intensity and a brownish tint. Then the lochia look like scanty spotting menstruation, gradually changing to normal transparent selection who accompanied the woman until childbirth. This means that the uterine mucosa has already fully recovered after the birth process and the pregnancy period.

How much blood flows after cesarean depends on the complexity of the operation and the postoperative period, as well as on individual features the body of a woman in labor, but most often this condition accompanies a woman for 1.5-2 months after the birth of the baby.

Pathological lochia

Lochia can be normal and pathological. The following types of pathological discharge are noted:

• lochiometer;
• bleeding;
• endothermite;
• thrush.

Lochiometer is a sharp decrease or complete cessation of lochia, accompanied by pain in the uterus, fever and chills. Bleeding is characterized by a constant bright red color of the lochia 3-4 days after the operation or a repeated change in the color of the discharge, for example, it was red, then turned brown, and after a certain period - red again.

The term endothermitis refers to inflammation of the uterus. This condition is characterized by yellow-colored lochia with an unpleasant odor, as well as fever body, pain in the uterus and an admixture of pus in the lochia, general weakness and fatigue.

Sometimes due to the use of antibiotics after surgery, a woman in labor develops thrush. This condition is also characterized by itching in the external genital organs.

If, after a cesarean operation, the discharge ended earlier than a month and a half later or continues to go on for more than 10 weeks, but the number, color and smell of lochia are normal, then you should not sound the alarm. This phenomenon is most likely due to the characteristics of the woman's body, although it would be useful to inform the doctor about this.

Black discharge immediately after childbirth, which is not accompanied by pain and an unpleasant odor, is provoked by hormonal changes in the postpartum period, so they should be taken as the norm. But if such a phenomenon appeared some time after surgery, you should immediately consult a doctor.

As soon as possible, a young mother needs to see a doctor if she finds the following symptoms:

• abrupt cessation of lochia;
• long duration of discharge, accompanied by pain in the uterus and aching in the lower back;
• the appearance of an admixture of pus in the lochia, a putrid smell and a change in their color up to green;
• the appearance of curdled discharge, accompanied by a trial in the genital area;
• copious with mucus.

In addition, you need to visit a doctor if lochia is accompanied by an unpleasant odor that resembles rotten fish. This condition may indicate the development of dysbacteriosis in the vagina.

Factors affecting the duration of lochia

In addition to the characteristics of the body of a particular woman in labor, other factors also affect the duration of lochia:

• season;
• enlargement of the uterus during pregnancy;
• lack of lactation;
• remnants of the fetal membrane in the uterus;
• structural features of the uterus.

It is noteworthy that discharges last longer in summer than in winter. In addition, the more the uterus has increased, the longer it will contract. The absence of lactation also affects, in which uterine contractions are less intense and, as a result, the period of lochia is lengthened.

The presence of small pieces of the fetal membrane in the uterus prevents the organ from fully contracting, which also leads to a prolongation of the period of postpartum discharge.

The structure of the uterus affects the duration of lochia in this way: an organ of a normal shape will contract faster than with bends and abnormal morphology.

For the prevention of pathological discharge, it is necessary not to neglect the rules of personal hygiene, to give preference to clothes made of cotton, not to start an intimate life earlier than 45 days after childbirth.

Diagnosis of pathological lochia

If the patient has complaints related to postpartum discharge, the doctor immediately conducts a thorough gynecological examination and prescribes general analysis blood to determine the level of hemoglobin, deviations from the norm of which indicate pathology, in particular, indicate bleeding. Additionally, ultrasound is prescribed to detect placental remains in the uterine cavity of the woman in labor.

Conclusion

In the postpartum period, it is necessary to pay attention not only to how long the discharge lasts, but also to its intensity, color and smell. This will help to notice the appearance of pathological lochia in time. In matters relating to the health of a woman who has recently known the joy of motherhood, it is better to play it safe.

After a surgical operation, the membrane of the reproductive organ needs time to recover. As a rule, the recovery period lasts from 5 to 9 weeks, but this is provided that there are no complications. If during natural childbirth the discharge is not abundant, and they pass on their own, then after a cesarean section, the woman must be closely monitored. After all, there are often complications.

Allocations after caesarean section - the norm

In the early period after a caesarean section, in most cases, doctors compare the discharge with heavy menstruation. In medical practice, they are called lochia, they are red in color and contain small clots.

When do periods start after a caesarean section?

How long does discharge last after caesarean?

After an abdominal operation for a week, a woman's discharge can reach 500 ml. In other words, the sanitary napkin fills up within 2 hours, which is considered normal after such a birth.

Of course, for many women it will seem that if the pad is filled every 2 hours, then this is a lot. In fact, after a caesarean section, a woman may have even more discharge. For example, during the physical activity of a woman, at the time of breastfeeding a baby, as well as during palpation of the abdomen. For these reasons, the natural contraction of the uterus begins to be stimulated, so they are expelled outward.

Additional causes of heavy discharge:

1. If there are remnants of decidual tissue in the uterine cavity.
2. With impaired blood clotting in a woman.
3. If after a cesarean section there is bleeding from a failed suture, directly on the uterine cavity.
4. With impaired contractile function of the uterus.

Around the second week, a woman's discharge becomes darker (brown). Gradually, the volume begins to decrease.

Note that closer to the 5th week after cesarean section, blood spots on the pad may be observed, this is also considered the norm. The secret gradually brighten and have a smearing character. If this does not happen, you should immediately consult a doctor.

Starting from the 8th week after the operation, the internal layers of the organ begin to recover. Therefore, the discharge after about 1.5 or after 2 months in the normal state of the woman stops.

Yellow and green discharge after caesarean

First, consider the secret of yellow. Every woman should understand that in the postpartum period this phenomenon is prolonged.

As soon as the placenta has separated, the inner layer of the uterus begins to look like an extensive wound. At this point, the endometrium is cleansed. Lochia should be abundant and red in color.

The main causes of yellow discharge after abdominal surgery:

1. They can talk about the presence of metroendometritis.
2. With postoperative infection.
3. With initial anemia.

In addition, yellow lochia can occur in women with a hematoma in the suture area on the uterine cavity.

If they are observed after childbirth, then you should immediately contact a gynecologist.

1. If the secret has a dark yellow tint.
2. There is an unpleasant odor.
3. Lochia profuse.
4. There is itching and burning.
5. There is a general malaise.
6. The body temperature rises.

Such a course and yellow discharge are pathological. Therefore, it is necessary to establish the exact cause of their occurrence and take appropriate measures.

As for the green secret - if a woman does not have a pain symptom, the temperature does not rise and the green lochia does not have an unpleasant odor, then this is considered the norm.

But, if the sign has an unpleasant odor and all the above symptoms, as in yellow discharge, then, most likely, proceeds inflammatory process. In most cases, in the inflammatory process, there is a lesion of the mucous membrane, directly to the uterine cavity.

Green discharge with an unpleasant odor after a caesarean section

A pathological sign may indicate endometritis. With such a disease, an inflammatory process occurs in the inner mucous layer of the uterus, in other words, in the endometrium. In addition to green lochia with an unpleasant odor, the woman also has a pain symptom in the abdomen, and the body temperature rises to high numbers. Very often, with acute endometritis, a purulent secret is noted, which has a pronounced clinical picture. Such secretions are quite abundant, in which blood impurities may be present.

If you do not start treatment of endometritis in a timely manner, this can be fatal, so you need to be more careful about the nature of the discharge after cesarean section. In case of any changes, you should immediately consult a doctor.

Green lochia, which have an unpleasant odor, can also indicate that a woman has chlamydia. Chlamydia is a group of diseases that are caused by microorganisms called chlamydia. In order to accurately determine this disease, it is necessary to undergo a comprehensive examination. Without fail, doctors prescribe a cultivated method, biological material is taken and the causative agent of the disease is detected. If a this method does not allow to make an accurate diagnosis, then in this case an immunofluorescent method is prescribed.

Additional reasons given symptoms with an unpleasant odor may indicate the presence of bacterial vaginosis, thrush or gonorrhea.

With bacterial vaginosis, white-gray traces are noted in the secret. The discharge itself with such a disease has a rather unpleasant odor, in addition, there is a strong itching in the genital area. As the disease progresses, they acquire a green tint and become thicker. In this case, there is also reddening of the genitals.

Bacterial vaginosis at the initial stage of its development responds well to treatment. But, if you do not turn to a gynecologist in a timely manner, then the disease becomes more complicated, thereby using drugs that already have an extensive spectrum of action, and the woman will have to give up breastfeeding so as not to harm the baby.

Green discharge may indicate that a woman has colpitis. The disease has a pronounced clinical picture, so pus or slight blood impurities can be observed in the lochia. Additionally, a woman is tormented by severe itching and an unpleasant burning sensation appears in the reproductive organs.

The most dangerous similar symptom that can occur in the postpartum period is when the cervix or fallopian tubes are affected. In such secretions, a large number of leukocytes are noted, therefore clinical picture becomes pronounced. They have an unpleasant odor strong pain in the lower abdomen, body temperature rises and general malaise is noted.

When to see a doctor?

A woman who has undergone a caesarean section needs to carefully monitor her health. Not everyone can recognize when this sign is considered normal, and when there is a danger, indicating the presence of a serious problem.

When lochias acquire an unusual color, have an unpleasant odor within 2 weeks, then this is already a serious reason. You shouldn't risk your health. In order to avoid complications, it is best to contact a specialist as soon as possible.

Treatment of green discharge after caesarean section

Medical therapy depends on the diagnosis. If a woman had endometritis at the time of the examination, then in this case a course of antibacterial medicines systemic spectrum of action.

If an infection is found, antibiotics are prescribed and antifungal drugs.

The course of treatment without fail includes taking multivitamin complexes, drugs will help to quickly restore the body after a cesarean section.

It should be noted that at systemic treatment you need to stop breastfeeding. Do not delay treatment for pathological discharge, otherwise more serious complications.

Prevention of purulent discharge after cesarean

Purulent lochia, which have a green tint, always indicate the presence of an infection that has penetrated during the period natural recovery.

The secret may indicate:

1. For the presence of endometritis in a woman.
2. Parametritis.
3. There was a postoperative adnexitis.
4. With obstetric peritonitis.
5. Sepsis.

At the same time, it is noted: a putrid smell, the secret becomes abundant. The woman's body temperature rises, weakness, dizziness and increased sweating are noted. At purulent secretions very often the heartbeat quickens and there is a pronounced pain sign in the lower abdomen.

Concerning preventive measures. A caesarean section is a rather serious abdominal operation that requires not only postoperative treatment by medical personnel, a woman must adhere to other important rules.

In the first month after the surgical operation, it is necessary to carefully treat the perineum. Processing can be done with baby soap or you can prepare a decoction of string or chamomile at home.

To prepare a decoction, you will need one tablespoon of a dry plant and 500 ml of boiling water. Mix everything, boil for a few minutes over low heat and insist for 30 minutes. Once the solution has cooled, the perineum can be treated.

During the first week after a caesarean section, do not use sanitary pads. They can create the effect of diaper rash, thereby contributing to the penetration of bacteria. During this period of time, it is better to use ordinary diapers or pharmaceutical gauze. Such materials have excellent "breathing" properties. Changing diapers or gauze is necessary every 2-4 hours, depending on the nature of the discharge.

To improve uterine contraction, gynecologists recommend that women after cesarean section lie on their stomach for 20-30 minutes in the first month. It would be useful during this period to apply a cold heating pad to the abdomen. Apply for 10-15 minutes 5 times a day, no more.

As a prevention of lochia, you can resort to a circular massage. If done correctly massage movements, then this will help to quickly reduce the ability of the uterus, thereby accelerating the recovery process.

Now you know which discharge is considered normal after a caesarean section, and which pathologies. If you have the above signs of an unpleasant odor, it is better to consult a doctor.