Smears after caesarean. The nature and duration of discharge after cesarean section

Some women notice brown discharge that begins to appear after childbirth. Undoubtedly, this scares new moms. This is especially true of those secretions that come out with blood clots. Allocations of this nature in medicine are called lochia. The clots are made up of endometrial particles that have died off, as well as plasma and placental cells. When should one be afraid of these secretions, and in what period are they considered normal, and in which not?

Discharge after childbirth after 2 months: causes and solutions

We note right away that with the discharge that appeared after the birth process, the uterus begins to make contractions in an enhanced form. How long this process will be depends on the individuality of each organism. After a woman has given birth, her body undergoes self-cleansing and at the same time it gets rid of the remnants of tissues and mucus. Those who have already passed this period know that it is with the contraction of the uterus that involution occurs and the stomach begins to decrease.

The uterus should be cleansed for a period of not more than 2 months. Be sure to pay attention during the entire postpartum period to the nature and duration of the discharge. Remember that they can change their color. Initially, the discharge looks more like menstruation, but it can change its color to yellowish-white, while it should not have a characteristic smell.

If the body recovers normally, then the discharge from the uterine area stops after 4 weeks. It is considered normal if by this time only smearing spots sometimes appear. Rarely, but it happens that the process is delayed for 6 weeks.

If the process of uterine contraction is delayed, then you should take it to the clinic to see a doctor who, through ultrasound, will be able to identify the cause.

The consequences can be different, there are 6 reasons for a prolonged discharge:

Availability inflammatory process in the uterus;
Formation of a fibrous node;
Uterine infantilism;
Poor blood clotting;
There was a bend of the organ;
The placenta did not come out completely.

In the latter case, a complete gynecological diagnosis and cleaning of the uterus in the mode of stationary observation is required. The presence of a characteristic odor in the discharge can also be dangerous. This is a signal that the inflammatory process has begun. Since postpartum discharge is considered an excellent environment for the development of pathogenic bacteria, if abnormalities are found, you should immediately contact a gynecologist.

Brown discharge after childbirth after 3 months

As mentioned above, postpartum discharge is typical for a period of up to 6 weeks, but this is a rare case. If the discharge does not stop 12 weeks after the baby was born, then it may be menstruation or the formation of an inflammatory process. The nature of the discharge is very important, they can be dark or light beige, but if you see black discharge, then you need to urgently call an ambulance.

If you notice the discharge is white and mucus predominates in them, then this may be postpartum thrush. If there are few of them and they are mostly transparent, then you should not be afraid, these secretions are considered quite natural. A lingering discharge that has neither color nor smell in most cases means the period of ovulation.

If a woman does not breast-feeding, then after 3 months she can normalize menstrual cycle, and the selection will mean the arrival of critical days. Standard menstruation will be accompanied by all known symptoms, these are pains in the lower back and lower abdomen, as well as hypersensitivity chest.

If bleeding is accompanied elevated temperature, severe malaise, it is necessary to urgently call ambulance. Only a specialist can make a correct diagnosis.

After 3 months, only those that do not bring discomfort, are colorless and odorless are considered the norm of discharge. In other situations, you need to go to the hospital and do an ultrasound to find out everything about the state of your body.

What does brown discharge after childbirth testify after 1 month

After 4 weeks of your baby being born, spotting will change to brown. This will indicate that fresh blood is not released, but only the remnant of the old comes out.

Sometimes dark brown discharge may be accompanied by white or yellow mucus. This also indicates that the uterine cavity is returning to normal.

Allocations should not give you discomfort, and their amount should be insignificant. The difference after 4 weeks will be noticeable.

Before the lochia has finished exiting, the uterus will have reached its normal size, and the inside will be covered with a mucous membrane. It is considered normal if in a month you still have spotting, the most important thing is that there are not many of them and they are not accompanied by symptoms of the disease.

Can there be brown discharge after cesarean section: normal or pathological

No reason to panic a quick ending or vice versa long discharge, approximately 10 weeks. Yes, the deadline has already gone beyond, but it should be noted that each organism is special. If you do not observe an unpleasant odor or a large number of lochia, then there is no reason to think about deviations. Although it is better to consult with your gynecologist.

Be careful, there is a special reason for joy if the discharge ended almost immediately after childbirth. Such a quick result often indicates the appearance of an inflammatory process that requires cleaning.

It is imperative to consult a doctor if the terms are out of the norm. This is a period or less than 5 weeks or more than 11-12. Both the first and the second indicator are dangerous.

In the first case, perhaps the endometrium for some reason could not come out and there is a chance of suppuration. In the second option, an inflammatory process or endometritis can begin.

Why brown discharge occurs after childbirth (video)

Now, after reading our article, you know how much the discharge goes and when a woman need not worry. Carefully follow the deadlines to know if the process dragged on, went too fast, or continues to go within the normal range. In any case, at the slightest premonition that something was wrong, it is better to consult a doctor, no matter how much you would like it, in order to undergo the necessary treatment if necessary.

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

Premature narrowing of the cervical canal leads to a violation of the outflow of secretions from the uterine cavity.
Planned caesarean section (lack of preparation of the birth canal, the cervix was completely closed by the time of the operation).
Violation of the contractile function of the uterus (there is no emptying of the uterus).
Refusal of breastfeeding (the process of feeding helps to reduce 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:

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).

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

Discharge with clots

Reasons for these withdrawals:

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

Clinical picture:

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

Diagnostics:

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.
Ultrasound: clots in the uterine cavity, expansion of the cavity, the niche of the scar on the uterus is heterogeneous.

Yellow highlights

Erased, abortive, mild form course of endometritis.
Infection of the postoperative suture.
Metroendometritis.
The presence of a long anhydrous period (more than 12 hours) before a caesarean section.
Pathological blood loss during surgery, or initial anemia.
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:

The uterus is enlarged.
Pulse increase.
Drawing pains in the lower abdomen.
Inflammatory changes in the blood (leukocytosis, ESR acceleration, shift leukocyte formula to the left).
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:

Sharp pain on palpation of the uterus and appendages.
The size of the uterus does not correspond to the period of the postoperative period.
Painful traction for the cervix.
Displacement of the pelvic organs relative to the midline (with parametritis).
Sharp pain in the area of the appendages (with adnexitis).
Severe inflammatory changes in the blood.
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 scanty bloody discharge, the patient complains of nagging pain, the size of the uterus exceeds normal.

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

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

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

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

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 (with the help of 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.

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.
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.
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.
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 terms that fit into the norm will allow you to control the real menstrual cycle, which should soon improve.

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 cesarean 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 the recovery period after surgery, 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.

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.

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.

Mucous discharge

If mucous secretions are 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.

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.

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.

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.

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 make her 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 surgery will be required.

Greens

It is not difficult to guess that the green discharge that began after cesarean is 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 by 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.

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 surgical intervention long rehabilitation period, during which the likelihood of complications in the form of pathological uterine discharge is high.

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

Why is there discharge after caesarean section?

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

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

What should be the normal discharge?

Lochia are first red, then brown, and at the last stage they become mucous. In order to 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 differs 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 discharge does not change, but there is pain during urination and acute pain in the 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 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 ultrasound.

White curds with itching

A white substance on underwear after a cesarean without accompanying manifestations is not a reason for worries or emergency hospitalization. They may appear 2 weeks after birth. Allocations white color, having a curdled 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.

25.09.2017 Smirnova Olga (gynecologist, GSMU, 2010)

The birth of a child is not only a joyful, fateful event, but also a huge stress for the body of the woman in labor. Regardless of whether the delivery process took place naturally or surgically, regenerative changes in the uterus will be accompanied by bleeding different intensity and tint. Let's figure out which discharge after cesarean means the norm, and which pathology.

Physiological processes after operative delivery

Caesarean section (CS) is an abdominal surgical intervention, the purpose of which is artificial delivery. The extraction of the fetus occurs through an incision in the anterior abdominal cavity and the wall of the uterus.

Many women mistakenly believe that together with the child and the placenta, the doctor also performs curettage during the operation.

Curettage is a surgical procedure during which, with the help of an appropriate instrument or a vacuum system, the mucous surface of the uterus is removed from foreign epithelial compounds.

Such a view is fundamentally wrong. Cleansing of the internal cavity occurs spontaneously with the help of lochia - mucous secretions that wash out the postpartum "garbage" from the fallopian tubes. This process is quite long, because during this period the uterus spontaneously decreases by more than 20 times. In fact, the cavity and the mucous membranes covering it are completely restored in the postoperative period, but before activating tissue regeneration processes, the body rejects dead particles left from the placenta and other epithelium that are not removed during cesarean, which come out in the form of blood clots and mucus - goofy.

Breastfeeding helps to develop the hormone oxytocin that is needed to speed up the process. Its "production" is accompanied by discomfort in the abdomen. The development of this component in women who have undergone a caesarean section. That is why additional administration of the hormone in the form of injections may be necessary.

Step-by-step description of discharge after surgery

Allocations after cesarean, schematically, can be divided into several stages:

The first postoperative period lasts about a week and is accompanied by a volumetric discharge of bright red, burgundy, and sometimes scarlet.
The second period can begin as early as the 2nd week after delivery. The amount of secretions is significantly reduced, they acquire a smearing character. Visually, the substance has a brown tint, and the blotches are almost invisible.
The third period can last about a month. The discharge is less active, more like a daub. Blood streaks almost do not stand out against the background of the general brownish secretion. At the end of the period, pigmentation acquires a yellowish tint. Such metamorphoses are associated with the presence of a huge number of leukocytes in the mucous substance. These secretions "wash" the walls of the uterus, preventing the development of pathogenic bacteria.
The last stage is marked by the appearance of a transparent substance and marks the scarring of the inner suture and the end of the recovery process after caesarean section.

How long does discharge last after a caesarean section?

Answer to this question directly depends on general condition the body of the woman in labor and the degree of complications received during the birth process. But, based on the scheme described above, we can approximately assume their duration. The physiological timing of uterine contraction, scarring of sutures and renewal of mucous membranes is from 7 to 9 weeks.

If the rejection of smearing physiological fluids lasts longer than the established norm of 2 months, but there are no putrefactive changes, a pungent odor and burning, and ultrasound showed no deviations, then we can talk about a significant drop in hemoglobin levels both after pregnancy and due to a difficult stage of recovery after cesarean. For the timely diagnosis of such a deviation, doctors recommend donating blood from a finger at least once every two weeks after surgery.

Most often, such a pathology is observed in women who combine the recovery process and breastfeeding. In this case, you must immediately seek help from specialists to prevent the development of anemia.

Find out when they will go on artificial feeding.

Little or no discharge after caesarean

There is no reason to rejoice if this process was completed much faster than the deadlines. The fact is that such a phenomenon indicates the development of pathological processes in the uterus and requires immediate medical intervention.

The duration of the discharge, as well as its color and consistency, allow the specialist to diagnose the recovery process after caesarean and possible deviations from the physiological norm.

The reason for the absence spotting after cesarean is a bend or spasm of the cervix. Such a pathology is fraught with the accumulation of rejected fluids in the uterine cavities, which, in the process of stagnation, begin to fester. When diagnosing such phenomena, you should immediately contact a specialist!

If the end of the discharge occurred earlier than 5 weeks after the operation, then this phenomenon indicates an insufficient contraction of the uterine muscle. Such a pathology can lead to the retention of rejected particles inside the body and start the process of decay. Relying on individual characteristics during the postpartum period, the doctor may recommend that the woman in labor go for a cleaning.

Long-term lochia

When discharge after cesarean section does not lose intensity for 10 or more weeks, a similar process may indicate the onset of internal bleeding or the development of endometritis.

Attention! Endometritis - extremely dangerous disease, characterized by the presence of an inflammatory process in the inner layer of the uterus-endometrium. This phenomenon requires immediate medical attention.

Depending on the duration of the inflammatory process, surgical cleaning under the cover of powerful antibiotics may be required.

Lochia ended and started again

It happens that a sharp cessation of discharge after a cesarean section, followed by a resumption. Among possible pathologies, this one is the most common. A similar phenomenon is associated with insufficient contraction of the cervix and, with timely access to a specialist, will not require repeated operable intervention.

You can increase muscle contractility with the help of special massage and oxytocin injections.

What does the color and consistency of lochia say?

Surgical intervention in the birth process entails a protracted regeneration process, which takes place not under the close supervision of a specialist, but at home, in parallel with caring for the child. Therefore, it is especially important to monitor the nature and intensity of bodily fluids rejected after cesarean. Timely fixed changes will help prevent the development of pathological processes.

Bloody lochia with clots

In the first days after the section, such symptoms should not cause concern for the woman in labor. These physiological fluids are associated with mechanical damage to tissues and blood vessels during contractions. It is necessary to carefully monitor the duration of this type of lochia after cesarean.

The bloody substance should be rejected by the body for 7-8 days. Longer discharges and their increasing volume may indicate the onset of bleeding!

The clots released during this period are particles of dead endometrium and the remains of the placenta. Their duration should also not exceed 7-8 days.

pink lochia

Most often, this type of discharge appears a month and a half after the CS. This symptom is not called the physiological norm, but they do not talk about the development of pathology either. The presence of pink discharge is associated with a protracted process of regeneration of mucous tissues or, most often, injury to the surface of the uterus. A similar complication is associated with the onset of sexual activity before the final restoration of tissues. It does not cause serious pathological conditions, but the appearance of pink discharge requires heightened attention in matters of personal hygiene.

brown lochia

Often, women notice the appearance of these discharges 6-7 weeks after surgery. In their structure, they are closest to the usual menstrual smear and are a physiological stage in the recovery process and do not indicate deviations.

yellow discharge

This phenomenon is considered physiological only in the first 2-3 weeks and only if a poor consistency is observed. An orange smearing viscous substance on a pad with a pungent odor indicates the initial stage of endometritis development, but abundant yellow mucous clots with putrefactive patches indicates an advanced stage of the disease, most often requiring surgical intervention.

black lochia

If a woman in labor noticed on the pad in the form of spots that do not have a specific smell, then, oddly enough, you should not sound the alarm. This substance is a physiological norm and its presence is dictated by hormonal change composition and quality of blood.

White discharge

Such discharge without concomitant symptoms may begin at the stage of completion of the excretory process. But the itching, redness, curdled consistency and characteristic, sour smell that have appeared require immediate diagnosis with a smear. This symptomatology may indicate a protracted thrush.

Mucous lochia after cesarean

Mucus, clearly seen in the discharge in the first days after cesarean, is a physiological norm and cannot be present in them for a long time. Its appearance is associated with the excretion of the products of intrauterine vital activity of the child.

watery lochia

Noticing an abundant transparent liquid, resembling urine in consistency and giving off an unpleasant odor associated with rotten fish, a woman should inform her gynecologist about this. Symptoms require immediate medical attention. Similar manifestations are characteristic of serious injury. circulatory system or lymph. And the substance is transudate, the liquid that fills them. Also, the cause of such an unpleasant discharge can be the development of vaginal dysbacteriosis.

Purulent discharge after caesarean section

This type physiological fluids is the most dangerous and indicates not just a deviation during the postpartum period, but the development of a serious disease inside the uterine cavity - endometritis. after cesarean may occur at any stage of recovery. Often, accompanying signs of putrefactive processes on the mucous membrane are an unpleasant odor of the substance, fever and acute pain in the lower abdomen.

Purulent discharge of a greenish tint can also indicate the entry during the recovery process after cesarean, infections:

Trichomoniasis

This disease indicates inflammation of the genitourinary system. Most often, it is transmitted sexually.

Bacterial vaginosis

It is a complex of non-infectious, non-inflammatory pathological changes with anaerobic microflora. Most often, such a phenomenon can be caused by a sharp hormonal change in the body and a dysbiotic shift. At the initial stages of development, the disease manifests itself as secretions of a gray tint with a sharp, rejecting odor, itching and burning in the groin area. The presence of thick, viscous secretions of a rich green color indicates the neglect of the disease and the need for the use of antibiotics.

Chlamydia or gonorrhea

These infectious ailments, first of all, are characterized by spotting, non-abundant secretions of a greenish tint and purulent properties. Accompanied by constant pulling pain in the lower abdomen and problematic urination, aggravated by sharp pain.

Colpite

This infectious fungal disease is accompanied not just by greenish smears, but by abundant mucous secretions of purulent properties mixed with blood, severe itching and burning in the perineum.

Please note, whatever the cause of the occurrence of purulent substances after cesarean section, such symptoms require immediate antibiotic intervention! A neglected problem can lead a woman to the operating table for curettage.

Discharge with odor

Not only the color and texture, but also the characteristic smell of vaginal fluids can tell a lot about the quality of the postpartum process.

Allocations, accompanied by a characteristic fragrance during the first 3-5 days after cesarean can be considered a physiological norm.

The presence of a sharp, “heavy” aroma in smears is the first sign of the onset of an inflammatory process in the uterus. Usually, such odors are provoked by the entry and spread of pathogenic bacteria.

Long, accompanied by a sour aroma, indicate inflammation of the uterine mucosa and, most often, are accompanied by sharp, cutting pains in the lower abdomen and in the perineum.

Prevention of pathological changes

Surgical delivery is a serious abdominal operation that requires not only postoperative suture treatment, but also special rules for personal hygiene and care for injured areas:

In the first month after caesarean, perineal treatment is recommended with each visit to the toilet. Depending on the situation, it can be a shower with baby soap or a special care product, a decoction of string, chamomile or calendula.
During the first week after the operation, obstetricians categorically prohibit the use of pads familiar to women. This remedy personal hygiene creates a “diaper rash effect” and promotes the development of pathogenic bacteria. It is recommended to replace the usual attribute with ordinary diapers or pharmaceutical gauze, which have excellent "breathing" properties. But it is advised to change impromptu pads every 3-4 hours.
To improve uterine contraction, gynecologists recommend that at least in the first month, lie on your stomach for 15-30 minutes.
For the first few weeks after a surgical delivery, it is advised to place an ice pack on the abdomen. A similar procedure is familiar to many women whose labor activity took place naturally. For them, a heating pad was applied immediately for several hours, and for those who underwent a section, it is recommended to apply for 5-10 minutes up to 5 times a day.
Circular massage movements also have a positive effect on the contractility of the muscles of the uterus and accelerate the recovery process after cesarean.
Immediately after the operation, the woman in labor is recommended to wear a postpartum restraint bandage.

Stages

Recovery

Discharge after childbirth and caesarean section are similar in many ways. Many women mistakenly call them heavy postpartum periods. This definition is incorrect in principle, because the discharge after the operation has a completely different mechanism of occurrence. The question of why they occur after a caesarean section worries women not so often. But the question of when they will end is very burning. In this article, we will tell you how long the discharge after a surgical birth lasts and how to understand that complications have arisen.

What are the allocations?

Doesn't have of great importance in what way a woman gave birth - both after physiological childbirth and after surgical ones, the so-called lochia (postpartum discharge) comes out of the genitals. They are a sign of the reverse development of the uterus, and this process is quite complex and lengthy.

During pregnancy, the uterus grows and increases in size, this growth is quite intense. As a result, a small female reproductive organ, whose weight does not exceed 50-70 grams, increases by more than 500 times by the time the baby is born. Since the uterus is a muscular organ, its smooth muscles are stretched, due to which such an impressive increase occurs.

After childbirth, it should shrink to its previous size. But it doesn't happen all at once. Both after childbirth and after cesarean in the first hours, the uterus remains large, but already has an elongated shape and strongly resembles a deflated ball. Contractions of the uterus contribute to the release of its internal contents, that is, lochia.

The placenta, which performed nutritional and protective functions for the child, is separated from the wall of the uterus, to which it managed to grow tightly in nine months with a network of blood vessels. During childbirth, the “baby place” is born by itself, and during operative childbirth, the surgeon removes it after the child is taken out and the umbilical cord is cut off.

In both cases, the vascular network, which has already become a link between the female body and the baby, is broken. Bleeding after childbirth is associated with this. With caesarean section, the situation is further complicated by the presence of a surgical incision on the wall of the uterus. An incision is a wound that bleeds extra.

This is due to the amount and color of discharge after caesarean section. They differ from the usual postpartum. Lochia after cesarean is more abundant, they may contain more blood clots. From time to time, in the first few days, lochia will intensify, this is due to periods of active uterine contractions. The woman will be given contraction drugs, because without them, the scarred uterus will involute more slowly.

The discharge in the maternity hospital is closely monitored by medical staff, since the nature of lochia can tell a lot about the doctor. At home, after discharge, the woman will have to observe the discharge on her own. This is very important so that you can pay attention to possible complications, if any.

Normal duration

In the first 8-10 hours after the operation, a woman must observe strict bed rest, after that it is imperative to get up, sit down, start walking so that lochia does not stagnate. Abundant bleeding usually lasts no more than five days. At the end of the first day, the edges of the wound on the uterus begin to stick together, fibrin threads help stop bleeding at the placenta attachment. Therefore, the very next day, blood clots appear in the discharge. He should not scare the new mother. They mean that hemostasis is normal, and the processes of blood clotting and rejection of blood clots continue to proceed correctly.

When the uterus begins to contract, the discharge with clots increases. So that a woman does not feel acute pain, in the first three days she is given not only reducing drugs, but also painkillers. By the fifth day of excretion, the consistency and composition change. Now, pure bloody lochia is being replaced by discharge with an increased content of serous serum. On the pad, it may look like a mucous ichor.

After a week, the discharge becomes even more mucous - the cervix begins to produce a large amount of cervical mucus, as the process of repairing the endometrium (the inner layer of the reproductive female organ). Around the same time, women may find brown blotches in the discharge, reminiscent of their appearance little worms. These are the tips of the surgical suture material, which did not enter the tissues of the uterus directly, and therefore, as the internal scar heals, they are rejected and brought out by the female body.

4 weeks after the operation, the number of lochia is significantly reduced, some may experience a brownish spotting. Moderate in volume and uniform in consistency, yellowish discharge without a sharp and unpleasant odor is also considered normal. By the 8th week after the operation, the discharge becomes transparent, gradually they return to their normal state.

It is believed that the normal period for the continuation of the discharge after cesarean section is 2 months, but shifts in terms of 2 weeks in one direction or another are acceptable.

Deviations

A caesarean section in itself is always associated with the risks of possible early or late complications, moreover, it is a gross interference with the natural order of things, and therefore the burden on female body in recovery period just colossal. During their stay in the hospital, they usually become noticeable early complications, which are manifested by profuse lochia, bleeding due to impaired hemostasis of a woman, due to injury to the vascular bundle during dissection, as well as an increase in temperature and a change in color and smell of discharge when the wound or uterine cavity is infected.

If the uterus does not contract well enough or does not contract, the bleeding is continuous and uniform, it does not increase or stop. Sometimes the discharge suddenly stops after a few days. Such situations call for immediate medical care, and it will certainly be provided to the puerperal. After being discharged home, the responsibility for controlling discharge falls entirely on the shoulders of the woman. What situations should you pay special attention to? For any that do not fit into the norm. Here are just a few reasons to see a doctor immediately:

spotting stopped, but after a few days it started again, they are quite plentiful;
10-12 days after the operation, blood clots reappeared;
rose heat body or subfebrile temperature lasts for several days

there are very few discharges in the first days or they completely stopped 1-2 weeks after surgery;
a substance of green, gray, brown, black color with an unpleasant odor is separated from the vagina;
lochia has been going on for more than 10 weeks and does not end;
in the discharge, the woman notices flaky blotches, the discharge has become very thick, itching has appeared in the perineum;
observed severe pain in a stomach;
bleeding or other discharges come not only from the genitals, but also from the area of the outer seam on the abdomen.

Pink mucous or watery discharge a couple of weeks after surgery and later may indicate difficult healing of the internal scar. This happens with an autoimmune rejection by the woman's body of the suture material used by surgeons, as well as with an early onset of sexual activity after surgery. Saturated yellow and green discharge at any time after surgery is a sign of an obvious infection, most likely purulent. They usually increase body temperature.

Watery discharge, almost colorless and quite abundant, can be an outgoing transudate in violation of the blood supply to the uterus, and thick white discharge with flakes can also indicate an imbalance in the vaginal microflora and a thrush that manifests after surgery. In all these cases, a visit to a doctor is mandatory. Self-medication is unacceptable.

Here are some important tips for women who have given birth.

In the hospital for the first three days, use only sterile hospital bed liners. No purchased pads, because they do not guarantee that pathogenic microflora will not enter the vagina.
When washing in the hospital and after discharge, water should not enter the vagina, as this increases the likelihood of infection. You also can't douche.
Pads for separation of lochia after caesarean section need to be changed more often than with normal menstruation. Liners in the maternity hospital - every three hours, sanitary pads at home - every 2-3 hours.

It is strictly forbidden to use tampons instead of pads.
You can live sexually only after the end of the discharge in the absence of other complications, that is, not earlier than 2 months after the operation.
It is forbidden to lift weights over 3-4 kilograms, squat, jump, fall. If such actions were nevertheless committed, and then the discharge increased or their nature changed, you should immediately consult a doctor.