Discharge and pain after caesarean. What should be the discharge after caesarean section? Prevention of purulent discharge after cesarean

Regardless of the process of childbirth - whether the birth occurred naturally, or by the method of abdominal surgery, postpartum discharge, or lochia, will be observed without fail. 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.

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.
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.
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 of the uterine wall.
Appearance of clear mucus 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 the postpartum recovery period for each woman may sometimes 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 on the sixth week after surgery completely stops the withdrawal of the postpartum secret, or, conversely, on the 10th week, the vaginal masses still continue to come out, 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 much bloody discharge and their volume go after cesarean section. 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 deviations from the process of restoration of the uterus.

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

For all the time of 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 surgery, a bright pink hue of the substance released from the vagina may be the result of early intimate relationships, when a thin layer of the young epithelium is injured.

Pathologies

Be wary of watery, almost clear secretions . 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 diseases.
The most unpleasant, requiring immediate treatment, are considered purulent discharge.. They occur with infectious inflammation of the mucosa, and they are characterized by 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 testifies 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, with an admixture of greenery and an unpleasant putrefactive odor, indicates the initial stage of 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 the uterus began to develop inflammatory process. Diagnosis is carried out exclusively by a doctor, and on the basis of clinical picture prescribes treatment.
Lochia white color 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 important factor indicating normal healing and recovery 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 smell that is different from the natural one, 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 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 washing with warm water of the 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;
it is strongly not recommended to use tampons, 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 profuse bleeding continuously observed for more than 8 weeks.
In the presence of pain in the lower abdomen, and if the pain progresses every day.
When itching occurs in the perineum.
With high body temperature, hypotension(low blood pressure), tachycardia (rapid heartbeat), anemia (cold skin).

Factors to Consider

For better uterine contraction simply need to wear a postpartum bandage.
Simple physical exercises 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 through caesarean section the uterus should recover. How the uterus is restored, what processes occur in a woman's body 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.
Very 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 physical activity entails 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?

After any childbirth, natural or operative, the internal mucous membrane of the uterus must be restored. Usually the entire regeneration period takes 6 to 8 weeks. At this time, they come out of the genital tract - they are called lochia. They consist of blood cells (erythrocytes, leukocytes and platelets), its liquid part - plasma, which seeps from the wound surface of the uterus, dead epithelium and mucus. Their color, composition, and volume changes throughout the postpartum period.

Normal discharge after surgical delivery

Immediately after the operation, the woman is in the intensive care unit under constant monitoring and medical supervision. Doctors monitor indicators of cardio-vascular system and condition of the uterus. If it is not reduced enough, it may begin early hypotonic bleeding. For its prevention, special substances are administered that cause contraction of the muscles of the uterus (oxytocin, methylergometrine).

In the first 5 - 7 days, red lochia with clots, resemble ordinary menstruation, but more plentiful, have a rotten smell. During this period, they can stand out up to 500 ml. A diaper or panty liner is completely filled in 1 to 2 hours. Every day, the doctor of the postpartum department examines the discharge and checks with the woman their number. Allocations increase when walking, palpation of the abdomen, breastfeeding - in these cases, the uterus contracts better and expels the contents outward;
Then lochia gradually darken and become red-brown in color. Their number is gradually decreasing;
By the end 4 - 5 weeks lochia lean dark spotting;
By 6 - 8 weeks the process of restoration of the uterine mucosa is completely completed. Allocations become light mucous and are no different from those before pregnancy.

The intensity and nature of the discharge in the first week after childbirth depends entirely on how well the uterus contracts. After this process slows down somewhat, as part of the muscle fibers has been damaged. To stimulate uterine contractions and prevention of late hypotonic bleeding the first three days they continue to inject oxytocin and advise the young mother to observe the following recommendations:

Go to the toilet on time because it's overcrowded bladder prevents good uterine contractions.
Breastfeed your baby on demand, not by the clock. Frequent attachment to the breast stimulates the production of a woman's own internal oxytocin. At the same time, during feeding, many mothers feel uterine contractions and increased secretions.

Features of personal hygiene in the postpartum period

The uterine secretions may contain various microorganisms, so during this period, you must especially carefully follow the rules of personal hygiene:

Change pad every three hours. It is better to use pads with a soft surface without fragrances.
It is categorically impossible to use tampons, as suckers linger in the uterus and microbes multiply faster there.
After each visit to the toilet, you need to wash with warm water from front to back. You can not douche and take a bath, so as not to bring the infection there. It will be possible to soak in the bath only after 8 weeks, when the uterine mucosa is fully restored.

Causes for concern

If there are any changes in the volume or nature of the discharge, it is imperative to contact medical care in the following cases:

The smell of discharge has changed, it has become sharp, purulent. This most often indicates the occurrence of endometritis - inflammation of the inner surface of the uterus. Body temperature rises, abdominal pain intensifies, general well-being worsens. endometritis develops more often than after natural childbirth.
The volume of bloody increased sharply or their number does not decrease for a long time- this indicates the development of late hypotonic bleeding. After cesarean, they occur more often, because due to the presence of a suture on the uterus, it cannot fully contract well. For heavy bleeding (more than one pad per hour), urgently call an ambulance.
Discharges abruptly stopped- the outflow of lochia from the uterine cavity was disturbed. This may be caused by a backward tilt of the uterus. If their stagnation is not prevented, then endometritis may develop.
Curdled discharge and itching in the vagina indicate the presence of candidal colpitis (). The risk of its development is associated with taking antibiotics after surgical delivery.

Period after caesarean section

Recovery menstrual function after childbirth, regardless of the method of delivery, it occurs individually for each woman. In the body of a young mother, the hormone prolactin is produced, which stimulates the production of breast milk and blocks the maturation of follicles in the ovaries, that is, it inhibits the possible onset of the next pregnancy.

Information If the child is on breastfeeding, then the first 5 - 6 months of menstruation in his mother are completely absent. Further, as complementary foods are introduced and the intensity of breastfeeding decreases, periods may appear at any time. In the beginning, they may not be regular, you should not be afraid of this. Sometimes menstruation appears only after the baby is completely weaned from the breast.

If for some reason the mother does not have milk or breastfeeding is impossible, then already 2-3 months after the birth.

Additionally Start off sexual life not earlier than 8 weeks after childbirth. Before this, it is advisable to visit your obstetrician-gynecologist, make sure that everything has healed well and discuss the method of contraception. You can plan a new pregnancy after a caesarean section no earlier than after 2 to 3 years.

After childbirth, the inner lining of the uterus needs recovery period regardless of the type of delivery. If there are no complications, then it takes no more than two and a half months. This article will focus on lochia after caesarean section and other possible discharges. Their features will be considered, and special attention should be paid to non-standard secretions that are not typical for a healthy body.

Discharge after caesarean

The discharge that may appear from the genital tract after a cesarean operation deserves special attention. In gynecology, they are called "lochia". They can change their consistency depending on the time that has passed after childbirth. It can be thick whites, but it all starts with bloody lochia. They include: dead epithelium, mucus, plasma, blood cells. Some women compare them to menstruation. But this is not at all the case, since lochias have an odor, can change their color and texture, and all these changes occur throughout the entire postpartum period. It is from them that you can determine the state of the body of a woman who has recently become a mother.

What is the difference?

Many women do not know how much lochia goes after childbirth, and how much after cesarean, and whether there are any differences between these two types. They believe that the discharge after surgery does not differ significantly from those that appear after natural delivery, but this opinion is erroneous. After all, a cesarean is an operation, and it causes severe stress to the body. After such an operation, a woman should be especially attentive to herself, her feelings and conditions. Even the smallest deviation from the generally accepted norm should be a reason to visit a doctor. It is worth considering the differences between the lochia that appear after childbirth, and those that women see after cesarean:

After a cesarean, the risk of infection or the onset of inflammation of the genital organs is much higher than after childbirth. This may be due to the fact that the wound surface is much larger. Therefore, it is important to follow all the doctor's instructions after the operation and perform each recommended procedure at least two to three times a day.
After natural childbirth, mucus in the discharge is not observed, but after a cesarean, especially in the first week, there is quite a lot of it.
Do not be afraid if the lochia is bright red in the first few days after cesarean. It is this shade that they should have during this period.
Uterine contraction after caesarean section takes much longer. It is because of this that discharge after surgery lasts one or two weeks longer than after normal childbirth.

Such discharge is the norm, so there should be no cause for concern. And many mothers are beginning to worry. This is especially noticeable among those women in labor who gave birth to their first child on their own, and the second was born by caesarean section, and, noting that the discharge has a different character, mothers begin to panic.

Duration

Very often, women ask the question: how long do lochia go after a cesarean section? And this question is really important, because it is by the timing that you can determine whether the recovery period in the body has dragged on. And also this information will allow a woman to approximately calculate the start date of the cycle, which is about to begin.

Normal discharge is considered to last from two to two and a half months. Therefore, even if approximately eight weeks have passed, and there is still discharge, this is not a reason to panic.
It is considered a deviation from the norm if, after the operation, the discharge stopped after six weeks or dragged on to ten, but this is not yet a reason to worry. Since in such cases it is necessary to take into account the characteristics of each female body separately. It is not necessary to ignore the composition and smell of lochia, their color and quantity, if all these indicators do not go beyond the standards, then you should not be nervous in vain. For absolute certainty that everything is fine, you can consult a gynecologist.
The reason for going to the doctor is the premature cessation of discharge, when they are gone after five weeks, or too long, when the lochia does not stop for more than ten weeks. Both cases carry the same danger. If the discharge ended too early, then, most likely, something did not allow the remnants of the dead endometrium to completely leave the body. There is a high probability that the process of festering has begun. In the second case, the diagnosis can be as follows: endometritis, as well as a gynecologist can diagnose the development of an infectious process. It happens that the discharge after cesarean was stopped in the right time, but after a while they resumed again. This is a clear sign that the process of restoring the uterus after childbirth was for some reason knocked down.

A woman in labor should have information about how much lochia goes after childbirth, which took place naturally, and how much after surgery.

Lochia character

As mentioned earlier in the article, over time, the nature of lochia after cesarean will change, and this is considered the norm. The first time after the operation will depart mainly blood clots, since the uterus during this period will be just an open bleeding wound. But over time, there will be less blood, and instead of it, mucus, cells of dead epithelium, and so on will appear.

These figures should also not be ignored. Prolonged bleeding indicates that the regeneration of damaged tissues does not occur in any way, and this will be the reason for a visit to the doctor. Next, it will be described in detail about each feature of the discharge, and how to respond to them.

Presence of blood

In the first few days, the blood in the secretions should not worry the woman, as this is considered the norm. Just like that, the process of healing of bursting vessels and tissues damaged during the operation takes place. In this matter, attention should be paid more not to the presence of blood, but to the timing of its release. If blood appears on the ninth day after cesarean, then you should immediately go to the hospital.

clots

During the first week after the operation, thick, white, odorless and itchy discharges can be observed in the discharge - these are cells of dead epithelium. Normally, they disappear after seven days, and the discharge becomes more liquid.

Slime

In the early days, mucus can also be added to the blood, the presence of which should not bother the young mother. Most often, mucus is represented by the products of the intrauterine life of the baby, which must certainly leave the mother's body.

pink discharge

A month after the operation, slightly pink discharge may appear, which signal to the woman that the healing has not yet ended. Although by this time this process usually already stops, but if this did not happen, then this is a sign that, due to some kind of mechanical effect, the tissues cannot recover in any way. Quite often this happens in those couples who did not listen to the recommendations of the gynecologist and resumed sexual intercourse ahead of time.

brown discharge

Normally, after a month and a half, the discharge becomes brown. This is due to the fact that the healing process is completed, the blood coagulates and is no longer as scarlet as it was at the very beginning. But you need to pay attention that brown discharge is considered normal only at the end of the recovery period. They shouldn't be there any other time.

Purulent discharge

Any woman will understand that purulent discharge is dangerous. This is usually a clear signal that inflammation of the uterine mucosa has begun. They have a yellowish-green color and acquire a rather unpleasant odor, and are also accompanied by a strong increase in body temperature. There may also be pain in the perineum and lower abdomen.

Watery discharge

If the lochia has become watery, then the mother should be on the alert, since this phenomenon is not normal. Often this is how a transudate comes out. This is a fluid that is contained in the bloodstream, as well as lymphatic vessels. This is a rather bad sign, since it clearly indicates that serious circulatory disorders have appeared. If the discharge not only lost its color, but also began to smell bad, then this is a clear symptom of vaginal dysbacteriosis.

If the birth did not take place in a natural way, then mommy must definitely monitor the state of her body after the operation, and especially the nature and timing of the discharge. Even the most inconspicuous impurities can be signals of violations.

Shades of lochia

Lochia color is another important point which should be kept under control. At the very beginning, the lochia have a red tint and turn brown towards their end. All other colors that will be described below are not the norm, and if they are found, the newly-made mother should immediately go to a specialist:

Yellow discharge. They can have a different character, and they cannot be left without attention. Yellow discharge by the end of the second or third week after surgery is considered normal, but they should be very meager and short-lived. On the fourth or sixth day, almost orange discharge may appear, having an unpleasant putrefactive odor - this is a symptom of endometritis, which has just begun to develop. If 14 days after the operation, the yellow discharge became abundant and mucous, then it is safe to diagnose endometritis, which in this case is already running. Every woman should remember that endometritis is not treated on its own.
Green highlights. The appearance of greenery in the discharge is a sign of pus. The latter appears if an inflammatory, infectious process takes place in the uterus. The reason for it can only be established by a gynecologist, after examining the patient.
White lochia. If, after the operation, a woman has abundant, odorless white discharge, then this is not a reason to run to the antenatal clinic. But if they carry with them an itch in the perineum, have a sour smell, acquire a curdled consistency, then this is a serious reason to take a smear. Since these are clear signs of an infection. Remember, you should not be nervous only in the presence of copious, odorless white discharge and other accompanying symptoms. In any other case, you should go to the gynecologist.
Black highlights. Black discharge after cesarean is natural and should not cause panic. It's just hormonal changes in the blood that occur in every woman. But a deviation can be considered if such discharge appears after a long time after the appearance of the baby.

Number of selections

The article has already considered almost all the signs of discharge: the color of lochia after childbirth, their nature and many other manifestations, but it remains to be said only about their number. A young mother should also pay attention to this fact. If the discharge after cesarean is too scarce, then this may indicate that the uterine ducts, tubes are clogged, or a blood clot has formed in them.

Too much lochia should also not please a woman, especially if the discharge in large quantities does not stop. This is a signal that the uterus cannot recover normally after the operation. In any case, you need to go to the doctor for an examination to find out the reasons for the appearance of such deviations and eliminate them as soon as possible.

It is also important to remember that not only attentiveness to changes, but also hygiene after a cesarean section will help maintain health. When discharged from the hospital, the doctor gives all the necessary recommendations regarding this, and it is highly undesirable to neglect these recommendations.

Conclusion

Almost all mothers do not like the period when lochia continues after a cesarean section or childbirth. But do not be so hostile to this phenomenon. Every woman should remember that discharges with a smell or containing too bright mucus should be especially alarming. Almost every such case requires immediate treatment with antibiotics or even surgery.

In this article, I would like to consider such a delicate issue as discharge after cesarean, since not all patients dare to ask me about it during consultations. And the topic is really very important. After all, it is precisely by the characteristics - their color, volume, smell that you can accurately determine whether everything is in order with the health of the woman in labor. So, let's take a closer look at how many days the discharge continues, what they should be like, and what they say about the deviations that occur in the body of a young mother who underwent a caesarean section.

How long does discharge last after caesarean section

Timing is a very important point in this case. It is this information that allows you to control the restoration of the menstrual cycle.

Normal discharge after cesarean can last up to 7-9 weeks. Just in time to completely contract and “push out” the dead particles of the endometrium that remain after the separation of the placenta. There is a slight margin of error in this indicator. That is, if the discharge after cesarean ended a week earlier or, conversely, a week later, there is no reason to panic. Frames may vary. Ultimately, how many days lochia goes depends solely on individual characteristics individual organism and its ability to recover. The main thing is to follow them:

composition;
coloring;
volume;
smell.

Below I will tell you what these indicators should be normal. And now about the situations in which it is necessary to be vigilant and contact a gynecologist. It is important to note exactly how much discharge you have after a caesarean section. When they ended too quickly (before 5 weeks), this may indicate that the particles of the endometrium cannot come out for some reason. In this case, there is a high risk purulent process in the uterus.

Have you already consulted a doctor?

YesNot

If lochia, on the contrary, is too long, there is a suspicion of infectious diseases genital organs and abdominal cavity. It is also impossible to exclude endometritis. All of these diseases can be treated if diagnosed early. But if you do not resort to therapy, serious pathologies and complications cannot be avoided.

It is also important not only how long the discharge after cesarean lasts, but also their stability. The condition should be alarming when the lochia ended, and later began again. This may indicate any failures in the process of uterine involution.

Important! Be extremely careful about the duration of the lochia. Ignored deviations in this process often end in surgical intervention.

What should be the discharge after cesarean

Lochia, which appear immediately after the operation, is very similar to normal menstruation, only very plentiful. But the secret is the same in color, may include small clots. Discharge after caesarean may increase as a result of physical exertion, with palpation in the abdomen, as well as during breastfeeding. These actions stimulate the contractility of the uterus, due to which its contents come out faster.

Consider, with a breakdown in time, what normal discharge should be after a cesarean section:

Week one. During this period, the total volume of lochia can vary within 500 ml. If the gasket fills for about 2 hours, we can say that at this stage the recovery process is proceeding normally.
Week two. The released secret gradually darkens, turns brown, gradually decreasing in volume.
Week five. Lochia acquire a light shade, smearing texture. Their intensity also weakens.
Week eight. Appear normal discharge, as well as before pregnancy, since by this time the uterus should already have almost completely completed the process of involution.

After surgical delivery, the uterus contracts worse than after natural delivery. The reason for this is the damage to the muscle fibers during the operation. The intensity and nature of lochia depend on this.

Important! In order to exclude postpartum hemorrhage and accelerate the involution of the uterus, I recommend that my patients establish it as soon as possible after the CS in order to stimulate the production of oxytocin in the body, which, in fact, is responsible for.

Types of discharge after cesarean

As I have repeated more than once, lochia is a marker of the health of a woman in labor. Allocations after cesarean gradually change in terms of abundance, density, color. Next, I’ll tell you what specific characteristics of them should alert a woman, and which ones are normal indicators.

Greens

If the lochia acquires such a color, this is one of the most dangerous signals that should never be ignored. Discharge after a caesarean section of a greenish tint is a clear sign of the appearance of pus.

As a rule, they are accompanied by an unpleasant putrid odor and appear as a result of:

inflammatory processes occurring in the uterus, which are caused by trauma to the reproductive organ or incomplete rejection of the fetal membrane;
decay of lochia accumulated in the uterine cavity;
infectious diseases.

In my practice, there have been cases when patients did not have green discharge immediately, but several months after childbirth, when the lochia stopped altogether. As a rule, this is a sign of endometritis, which proceeds in a slow form. Even pain and there is no discomfort, you should immediately go to the hospital. Green-colored lochia, especially if it is frothy, may also indicate the presence of trichomoniasis gonorrhea, chlamydia, or gardnerella. However, thrush is also often the cause of the problem. But it is imperative to find out the provoking factors, especially if, in addition to the greenish secretion, you are concerned about the redness and itching of the genital organs, which is typical for bacterial vaginosis and colpitis.

Brown

Brown discharge in the first week after a caesarean section is normal. The rest of the time, a woman in labor needs to be extremely attentive and respond in a timely manner to any changes. So, if the lochia has darkened, a putrid or sour smell has appeared, go to the doctor. Often, these symptoms indicate an infection present in the body or a complex inflammatory process. A visit to the gynecologist is also necessary if, after a cesarean section, the discharge not only turned brown, but also their volume increased sharply. This usually occurs as a result of internal bleeding. The cause may also be an afterbirth, which has not completely departed and prevents uterine contraction.

The consistency of lochia is also very important - if they are brown and too thin, you may have vaginal bacteriosis. Body temperature also matters - elevated to subfebrile or higher rates, it indicates pathologies in the body.

Violations are also evidenced by:

itching in the perineum;
weakness;
nausea;
frequent urination;
whitish flakes or pus in the discharge;
chronic fatigue;
sleepy state.

yellow discharge

Lochia turns yellowish about three weeks after birth. If the uterus contracts weakly, they can continue in this form for up to two months and are not an indicator of complications. During this period, the secret, as a rule, contains bloody inclusions, which indicates the continuation of the recovery period. Yellow discharge that appears after a caesarean section or a normal birth is considered normal if it is not very bright and is not accompanied by elevated temperature and other unpleasant symptoms.

The presence of any pathological signs signals the need to contact your doctor. Dangerous discharges are yellow color, at which:

rises (even slightly) body temperature;
pain in the lower abdomen;
aching lower back;
there are impurities of pus in the secreted fluid;
an unpleasant odor appears;
there is burning and itching in the genitals.

These symptoms often indicate a disease such as inflammation of the uterine endometrium (endometritis). In the postpartum period, the likelihood of its occurrence is especially high.

Pink

As a rule, the pink shade of lochia indicates that the body of the woman in labor has not yet fully recovered. If the discharge acquires a light or pale scarlet hue much later after the operation (after a month or more), it is possible that some mechanical effect was applied to the wound surface, as a result of which it was damaged. This often happens if a woman in labor, without waiting for completion rehabilitation period started having sex.

Only a specialist can accurately determine why the lochia has acquired such a shade with the help of ultrasound and examination of the abdominal organs, as well as a number of tests. It is quite possible that the examination will show that these are the individual characteristics of your body, and pink discharge is a normal phenomenon. On the other hand, they can talk about internal trauma, divergence of sutures, the presence of polyps or erosion.

White

White discharge that began immediately after delivery, if they are not accompanied by additional symptoms, does not pose a danger. But you need to be careful not to miss the warning signs in the form of:

redness in the intimate area;
itching in the perineum;
sour smell;
curdled consistency of the secret.

If a patient comes to me with complaints of white discharge, which is accompanied by the listed signs, I refer her to taking a smear from the vagina or bacterial culture of the microflora. Only these tests make it possible to make an accurate diagnosis and subsequently choose the right therapy.

black

When a black secret is released in the first few days after the transfer of a young mother from the ward intensive care into the general, while the discharge has no smell, pain does not occur - this is the norm. In this case, the cause is the hormonal transformations that occur in the body of the woman in labor. But when they appear some time after surgery, they talk about the existing deviations.

With an unpleasant odor

Let's consider in detail how lochia can smell, and what it says:

1. The smell of charm, which is associated with dampness and mustiness. At the very beginning, lochia may smell of blood, and when about 10-12 days pass after childbirth, these rotten notes may appear. If the aroma is barely audible, this is considered normal. When, on the contrary, it is too intense, sharp, causes discomfort, the reason is non-observance of hygiene rules. Frequent washing and regular replacement of pads will help.

2. The smell is sour or fishy. Usually, grayish or white discharge is added to it, which is a clear sign of a violation of the microflora. It can be caused by antibiotics, antiseptics used to treat postoperative sutures, or, as in the previous case, personal hygiene errors. White cheesy lochia with a sour smell can also indicate vaginal candidiasis (thrush) and are treated with antifungal drugs.

3. Putrid, sharp. A clear sign of inflammatory processes occurring in the organs of the reproductive system. Despite the fact that the probability of infection during the operation is extremely small (unless, of course, the delivery was taken by a qualified specialist), but the risk still exists. Based on the localization of the pathogen, a woman in labor may develop: puerperal ulcer, perimetritis, peritonitis, parametritis, colpitis or endometritis. The course of the disease can be both acute and chronic. In the first case, inflammation develops rapidly, accompanied by severe pain, elevated to critical temperatures (above 39 degrees), the presence a large number pus in lochia. With a sluggish process, the accompanying symptoms are similar, but not so pronounced. The temperature in such situations does not rise above subfebrile, the pain is aching, weakness is also felt.

4. The smell of urine (urine). It is often caused by fistulas that connect the vagina to bladder or urethra. Pathology can be caused by tissue damage during surgical procedures. As a result, urine enters the discharge, which provokes the appearance of an unpleasant odor. Fistulas can also manifest themselves with increased urination, accompanied by cuts, burning and pain.

Important! Any discharge after caesarean with an unpleasant and unusual odor should cause concern in a woman and be a reason to contact a doctor!

Bloody issues

After a caesarean section, the presence of blood in the discharge should not frighten a young mother. In this case, she only says that the process of healing of broken vessels and damaged tissues proceeds in accordance with the norm. But here it is very important to pay attention to how long it lasts. If spotting does not go away even a week after caesarean section, an additional examination is required to rule out possible pathological bleeding that has opened as a result of a rupture of the vagina or cervix.

Rarely, such phenomena can also be caused by diseases such as hemophilia. But, as a rule, the doctor knows in advance about the presence of such a pathology in the patient and takes the necessary measures to avoid complications.

Purulent discharge

Define by outward signs the presence of pus is easy. Lochia at the same time look opaque, homogeneous, have a yellowish or greenish tint and a sharp unpleasant odor. May be accompanied by fever and pain in the abdomen, which is very dangerous. After all, purulent discharge that appears after cesarean is a clear indicator of infection.

The fact is that postpartum uterus- an ideal background for the development of inflammation and the spread of pathogenic microorganisms. After all, it is in a warm, humid environment that bacteria multiply at an incredible rate. The presence of wounds and remnants of dead tissue further contributes to this. And if a woman in labor does not comply with hygiene measures with sufficient quality, the situation is extremely aggravated.

It is worth noting that the above conditions favor the fact that the infection can develop both in the birth canal, and in the pelvic organs or in the abdominal cavity, and cause more serious consequences in the form of suppuration in the uterus, for example. Self-treatment in such cases is very dangerous and may lead at least to the need for a second operation.

It is possible to assume a probable causative agent of infection even by the type of discharge. If it is trichomoniasis, then the secretion is frothy and yellowish. With gonorrhea - greenish and liquid. It is possible to finally determine the "culprit" only through laboratory tests.

Norm and deviation

So after caesarean delivery may last up to 6 to 10 weeks. A deviation up or down in 1 week is allowed. According to statistics, the endometrium takes about 8 weeks to fully recover. Before the expiration of this period, it is lochia, not menstruation.

The duration of discharge also depends on the presence of organ injuries. reproductive system obtained during the surgical intervention. As the muscle tone is restored, the mucous layer is restored and, in general, the involution of the uterus proceeds, lochia can change the consistency, volume, color and other characteristics. For convenience, I will set out in the table which discharge indicators are considered normal in a given period.

If after some period of time you notice that the discharge after cesarean has disappeared, you can assume that your body has fully recovered.

The existing deviations are indicated by lochia, which last longer than the period indicated above, and their characteristics do not correspond to those that I indicated in the table.

Be sure to see a doctor in the following situations:

It's been two months since your CS and you're still bleeding. The described situation requires an urgent examination of the uterine cavity to exclude the presence of placental remnants, endometrial particles, and blood clots.
Mucus appeared in the lochia. If no more than a month has passed since delivery, there is no reason to panic. But more later dates there should be no jelly-like secretion.
There was an unpleasant smell. Above, I talked in detail about what this phenomenon can talk about. If ignored, the risk of sepsis will increase exponentially. With early treatment, the problem is easily eradicated with antibiotic therapy. In advanced cases, postpartum cleansing cannot be avoided.
Already in the first days after the birth of the crumbs, the mother has a transparent secret. Such an indicator is the norm only at the final stage of the recovery period. The rest of the time, it indicates that the uterus contracts very weakly. The cause may be a spasm of the cervical canal, which must be diagnosed and eliminated.
The lochia stopped and soon started again. This can be caused by high physical activity or trauma to the organs of the reproductive system (for example, during sexual intercourse).

Doctors' opinion

I share a quote from my colleague, an obstetrician-gynecologist with twenty years of experience, Elena Sidorenko: “The first thing I always try to explain to my patients is that discharge after a caesarean is not a regulation. And do not panic when they are too long. On the contrary, meager lochia, which ended very quickly, should be of concern, as this is an indicator of a failure in the recovery process.

What should be more alarming is not even how long the discharge takes, but their characteristics after a cesarean section. Even if they last more than two months, but they do not have an unpleasant odor, gray, green or rich yellow blotches - excellent. After all, this suggests that your uterus is completely freed from endometrial particles and dead cells, returns to normal, there are no complications and infections.

Of course, a woman who has recently given birth to a baby should be very attentive to herself - do not lift weights, keep her body clean, exclude bad habits. After all, by 80% it itself affects its own condition and reproductive health.”

Conclusion

Above, I told in detail what the discharge after a cesarean section can be according to its characteristics, explained how much they go, when they start and end. But it is worth considering that the terms and indicators listed by me may vary. It all depends on the individual characteristics of the body of the woman in labor. The main thing is to keep the situation under control and notify the attending physician about any changes in the nature of lochia, especially in situations where they:

became very profuse with impurities of bright blood;
acquired a green or gray tint and an unpleasant odor;
ended and started again after a while;
become white or watery;
are allocated in too small a volume;
come out with blood clots.

In addition, symptoms such as a sharp drop should alert blood pressure, weakness, blanching of the skin, impaired urination, pain in the abdomen and lower back, redness and itching in the area of the seams and genitals.

Important to remember! If you are driving healthy lifestyle life, adhere to all the recommendations of specialists and observe personal hygiene both before and after cesarean section, the risk of any complications is practically absent.

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Allocations 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. The female body during the recovery period is weakened, the protective environment of the genital organs is not restored, therefore additional measures against infection are needed.

Allocations are becoming poorer, "smearing", serosanguineous and, finally, colorless. This means that the lochia has stopped, and the woman's reproductive system has 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 the operation, blood comes out of the vagina, because the suture 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 contraction of the uterus, which in a short period should restore its previous size, shrinking 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 quickly get rid of secretions, you need to move a lot and monitor regular bowel cleansing, which sometimes has to be stimulated with 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 several days after stopping 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. It is better to contact the antenatal clinic 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 exercise. The cessation of secretions is a sign of involution, i.e. complete recovery of the 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 the mandatory hygiene procedures, dressings are made 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 seek medical help, otherwise you can end up in 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 is no indication 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.