home Audience 2 If the uterus does not contract after caesarean. Possible complications after caesarean section. Complications after caesarean section

If the uterus does not contract after caesarean. Possible complications after caesarean section. Complications after caesarean section

Not in all cases the child is born naturally. In the presence of medical indications to remove the baby from the womb, they resort to a caesarean section. This procedure does not differ in complexity and has been used in obstetric practice for a very long time. However, due to the fact that during the operation the uterus is dissected, its recovery is much more difficult and longer than after natural childbirth. How long does uterine contraction last caesarean section? How to speed up the postoperative period and avoid complications?

What is the condition of the uterus after the operation?

Caesarean section is a necessary measure. To extract the fetus from the mother's womb using this technique, the uterus is dissected in the classic vertical or transverse manner. The first method is rarely resorted to, since an incision made vertically at the top of the genital organ, due to the presence of a large number of vessels, provokes heavy bleeding. Vertical incision is used in cases where the operation is performed urgently.

The transverse method of caesarean section, in which the incision is made along the lower fold of the abdomen (pictured), is the most preferable, because it is characterized by less blood loss and trauma. In addition, the risk of postpartum infection is reduced and the period of regeneration of damaged tissues is reduced.

Regardless of the method of dissection of the uterus during the operation, this organ is subjected to much more significant damage than during the birth of a child in a natural way. For this reason, its recovery takes longer than with self-delivery.

The volume of the uterus after caesarean section is increased, its walls are greatly stretched. Inside and out, it looks like one big bleeding wound.

The uterine fundus at the end of the operation is lowered by 4-5 cm in relation to the navel. The diameter of this organ is about 10–12 cm. There is a suture on the uterus after cesarean, which is a tissue connected with self-absorbable threads.

Restoration of the organ after caesarean section

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In how many days will the uterus fully recover after delivery by caesarean section? How long this period lasts depends on many factors, but in most cases the recovery process takes about 2 months.

In the postoperative period, it is extremely important to observe the nature of the discharge, the state and speed of healing of the suture, as well as the features of uterine contraction. Timely elimination of identified deviations from the norm will avoid the development of complications, which is why it is so important to have an idea of what should be uterine secretions and what role does a suture play after a caesarean section in recovery.

The nature of the discharge

After delivery using this method, lochia is released from the vagina, as in the case of natural childbirth. The color, consistency and volume of secretions are importance, since by these indicators it is possible to determine whether the uterus is contracting correctly, as well as to identify the existing pathological process. Experts recommend monitoring lochia every day and informing your doctor if any abnormalities are found.

In situations not burdened by complications, the discharge completely stops 6-8 weeks after the birth of the child. Information about what lochia should normally be is presented in the table.

Stage recovery period	Color	Consistency	Quantity
First 3 days after surgery	bright red	Liquid	Very plentiful (postpartum pads get wet quickly)
4–10 days	Pink brown or brown	In the form of an ichor interspersed with blood streaks	Minor (the need to use a pad still remains)
End of 2nd week	Yellowish or whitish	Smearing	Virtually absent
Start of the 3rd week	Light	With inclusions of mucous elements	No need for gaskets

What role does the seam play?

Its contraction largely depends on the suture on the uterus. In the incision area, a dense connective tissue formation should form on it, resulting from tissue regeneration. This area is more rigid than smooth muscle.

In addition, the connective tissues do not stretch well, and the movements of the uterus during contractions and relaxation cause discomfort.

In most cases, the formation of the scar takes about 6 months after the birth of the child. In other words, an independent process also flows in the area of the cut. Along with this, the condition of the seam on the abdomen is also important. Damage sustained during surgical intervention, weaken the muscles of this area, which also does not have the best effect on the contractility of the uterus.

After a caesarean section, the incision is usually sutured with a single-row or double-row suture without interruption. At the same time, such types of threads are used as self-absorbable materials, such as:

dexon;
monocryl;
vicryl;
kaproag and others.

On postoperative stage doctors control the wound healing process and make sure that there is no inflammation at the site of the surgical intervention. After finishing labor activity to reduce pain for several days, it is recommended to use painkillers. Since the formation of the scar takes at least 6-7 days, the woman will be able to take a shower on her own only a week after the operation.

To alleviate the condition, doctors recommend that patients bandage their stomach with a diaper or wear a special bandage. You can go in for sports no earlier than 2-3 months after the operation. At the same time, the loads should be gentle, and it is better to completely refuse to lift weights in order to avoid the formation of hernias and divergence of seams.

Contractions and return to normal size of the uterus

As noted earlier, how quickly the uterus contracts depends on the quality of the stitches on it and on the abdomen. The weight of this organ immediately after childbirth is 1 kg. Over time, it begins to gradually shrink, acquiring a normal size. The final restoration of the uterus, as a rule, is completed no earlier than 3 months after birth. During this time, it is constantly decreasing.

At first contractile activity very weakly expressed, because in the process of surgical intervention, tissues, blood vessels and nerve endings. However, after a certain time interval, uterine contractions intensify, and its restoration normal sizes is accelerating. The table shows the indicators of the standard process of recovery of this organ after caesarean section.

Possible complications after surgery

After a caesarean section, as after any other type of surgical intervention, the development of various complications is possible:

damage Bladder, intestines, parametrium, vessels, presenting part of the fetus;
hematoma on the uterus;
profuse blood loss;
adhesive formations;
inflammatory process;
violation of the contractile function of the uterus;
circulatory disorders and increased blood pressure in the basin of the portal vein;
deterioration of the veins.

Unlike physiological childbirth, delivery using caesarean section is characterized by large blood losses. If in the first case the volume of blood loss is about 300 ml, during surgery this figure can reach 1 liter. Heavy bleeding may require a blood transfusion. In severe situations, extensive blood loss leads to resection or removal of the uterus. In 1 case out of 100 during the operation, doctors resort to the help of an intensive care team.

How to accelerate uterine contractions and body recovery?

What should be done to speed up the recovery of the uterus? To activate its contractile activity will help:

Physical activity. After agreement with the attending physician, within a few hours after delivery, lying on your back or on your side, you can begin to roll over in bed, move your arms and lift them up, gently pull in your stomach, bend your legs and rotate your feet. Later, you can do these exercises while sitting.
Kegel exercises. By improving blood circulation in the pelvic organs, they allow you to shorten the uterus as soon as possible.
Self-massage of the abdomen. Careful strokes from right to left accelerate the recovery of the reproductive organ.
Wearing a bandage.
Compliance intimate hygiene. Doctors recommend changing pads as often as possible, regularly washing the genitals with soap, and treating the seam.
Prevention of overcrowding of the intestines and bladder.
Breastfeeding the baby (if the mother does not take drugs that are dangerous for the baby).

Difficulties in the postoperative period

After removing the child surgical method The woman faces a number of problems:

pain while getting up from bed, coughing and walking and associated passivity;
violation of intestinal motility and the formation of a large amount of gases against this background;
difficulties with lactation arising from the fact that the child is brought for feeding only after 3 days from the date of the operation;
inability to lie on the stomach due to a protruding and painful seam.

From the inside, the uterus is a huge wound, and it is most damaged in the area where the placenta was attached, it is there a large number of thrombosed vessels. In addition, on the inner surface of the uterus there are remnants of the fetal membrane and blood clots.

Normally, the uterine cavity should be cleansed within the first 3 days. In this process, a significant role is assigned to phagocytosis (phagocytes are leukocytes that are able to dissolve bacteria) and extracellular proteolysis (dissolution of bacteria with the help of proteolytic enzymes).

Thanks to these processes, a wound secret (lochia) is released from the uterus. In the first days, lochia is bloody discharge, on the 3rd-4th day they become serous-suicidal with a high content of leukocytes, by the end of the third week, the uterine discharge should be liquid and light, and disappear completely by the sixth week.

However, if we say about the restoration of the epithelium of the uterine cavity (inner shell), then it occurs after about 3 weeks, the site of attachment of the placenta is restored towards the end of the postpartum period.

How long will it take?

Typically, uterine contraction takes an average of one and a half to two and a half months. In this case, the most active decrease in the volume of the uterus occurs in the first days after childbirth.

So, immediately after childbirth, the size of the uterine os in diameter is about 12 cm, and this allows, if necessary, to insert a hand into the uterus to remove the remnants of the placenta.

However, already after the first day, the entrance to the cervical canal narrows to the point that only two fingers can enter it, on the third day - one. The completely external uterine os will close around the third week.

At the same time, if immediately after birth, the weight of the uterus is 1 kg, That after 7 days it will be approximately 500 g, after 14 - 350 g and by the end of the postpartum period, i.e. after 2-3 months, the uterus will reach its prenatal size with a weight of approximately 50 g.

It is worth considering that the process of uterine contraction is accompanied by slight cramping pains in the lower abdomen, and they are most pronounced and intense after repeated births.

If these contractions are very painful, then after consulting a doctor, certain painkillers or antispasmodics can be used to reduce pain, but it is better to do without them.

However, it happens that in some women in labor the uterus does not contract after childbirth (atony) or it contracts, but very slowly (hypotension).

Both options are dangerous for a woman's health., as they can cause or a number of other complications.

The uterus does not contract: what is the reason?

Among the most common factors, affecting the slowdown of uterine contraction after the birth of a child, gynecologists distinguish:

the number of fetuses a woman bears;
location of the placenta;
difficulties that arose during pregnancy or childbirth;
large weight of the child;
women's health status, etc.

So, for example, uterine contraction is slower in women whose pregnancy was:

or complicated (hypertension, nephropathy, etc.);
if there was a low attachment of the placenta;
the fruit was large enough;
the body of the woman in labor was severely depleted;
labor activity proceeded poorly;
after childbirth, the woman behaved very passively and practically did not move.

Don't shrink at all after childbirth, the uterus can in the case of:

her inflection;
birth canal injuries;
her underdevelopment;
inflammatory processes in the appendages and the uterus itself (including in the past);
fibroma (benign tumor);
blood clotting disorders, etc.

If the uterus contracts slowly

Immediately after the birth of the child a cold heating pad is applied to the belly of a newly-made mother, this helps to stop bleeding and accelerate uterine contraction.

For several days that the woman in labor will be in the maternity hospital, doctors will constantly check the condition of the uterus and the level of its contraction.

Establish low uterine contractility the gynecologist can during a routine examination of the condition of the bottom of the uterus (in this case it will be soft).

And a woman should not be discharged from the hospital until the doctor is sure that the uterus is contracting at a normal pace.

If the gynecologist sees that the uterus cannot contract on its own, he appoints a woman special preparations that enhance its contractile activity ( prostaglandins or oxytocin), as well as, if necessary, external massage of the fundus of the uterus, which is carried out through the anterior abdominal wall.

The main impulse to accelerate the contraction of the uterus is breast-feeding Therefore, we advise you to start breastfeeding your baby as soon as possible.

It is also recommended to move a lot (if possible) and lie down on your stomach more often, and even better - sleep on it. You should not neglect the rules of personal hygiene, namely, regularly wash, treat wounds, etc.

Significant effect on the level of uterine contraction has regular bladder emptying. Women often do not pay due attention to this fact, especially since if they were imposed after childbirth, because then urination brings a lot of pain. However, despite the pain, you should try to go to the toilet as often as possible.

Usually, after childbirth, the uterus is actively reduced in those women who did not avoid a little physical activity during pregnancy. Therefore, we advise you to walk as often as possible during pregnancy. fresh air, do simple homework and do .

If all of the above methods did not have the desired effect and the uterus still does not contract, the way out of the situation may be. The fact is that lochia can remain in the uterine cavity ( postpartum discharge) or part of the placenta or the uterine os may be clogged with blood clots formed.

Without cleansing, all this will inevitably lead you to the development of an inflammatory process, and, perhaps, not only in the uterus itself, but also outside it. If this does not help, unfortunately, the consequences for the woman become even more serious: they will have to undergo surgery or, in the worst case, even remove the uterus.

But, fortunately, healthy women who follow all the recommendations of doctors, as a rule, does not occur serious problems with contraction of the uterus after childbirth. So take care of yourself and be healthy!

Expert comment

The delay in the contraction of the fetal organ is called subinvolution of the uterus. Usually the uterus contracts to baseline by the end of the sixth week postpartum period. In non-breastfeeding women, by the end of the eighth week.

The most rapid contraction of the organ occurs immediately after the birth of the child. The length of the fetus is on average 40-50 centimeters. In utero, the child is in a folded state: the legs are pressed to the body. The length of the uterus before childbirth is 35-38 centimeters, and after childbirth, it is instantly shortened. Instead of two thirds of the growth of the fetus, the size of the uterus becomes comparable to the head of a newborn.

Changes hormonal background women. The production of growth hormones stops. Instead, they synthesize substances aimed at restoring the body.

The human body is undeniably unique. But in relation to other mammals. The basic processes are typical reactions, and postpartum period is no exception.

Uterine contractions are an indicator of the course postpartum process. Only by the size of the uterus can one judge the general condition of the puerperal. When the uterus contracts normally, then everything goes as it should. If there is a delay in uterine contraction, you do not need to do expensive tests to understand that the postpartum period is going with serious failures. Both immune and hormonal.

After delivery by caesarean section the contractility of the uterus is much lower than after childbirth through the natural birth canal.

Therefore, recently, puerperas who underwent a Caesarean section, getting out of bed as early as possible as soon as they leave side effects from anesthesia. Movement contributes to contraction, and inactivity leads to lethargy. Including the muscular layer of the uterus.

Dynamics of uterine contraction in the normal postpartum period

After the discharge of the placenta, the height of the fundus of the uterus is determined at the level of the navel. Each subsequent day of the postpartum period, the bottom of the uterus sinks to 1.5-2 cm. By the time of discharge from the maternity ward - on the sixth day - the height of the fundus of the uterus should be no more than 4-5 cm from the womb.

A delay in uterine contraction for at least one day is considered a pathology.

Causes of subinvolution of the uterus

Causes of delayed uterine contraction may be hormonal disorders, anatomical defects, infectious agents.

Hormonal disorders

Lack of prolactin- a hormone responsible for the production of milk. Even in non-breastfeeding women in childbirth, the initial levels of prolactin, the main parental hormone, remain at a fairly high level on the first day of the postpartum period.

The production of prolactin entails an immediate release of oxytocin, a hormone that contracts the muscles of the uterus. Prolactin is produced reflexively, when the nipples are irritated. Therefore, in nursing puerperas, uterine contraction occurs much faster.

Lack of prolactin leads to a decrease in uterine contractility. Great importance has a central regulation of the cerebral cortex. With the desired child, the production of prolactin is much higher.

Anatomical causes

Remnants of the placenta attached to the wall of the uterus prevent it from shrinking.. Just as a person cannot move a hand in a cast, so the uterus cannot fully contract, constrained by an attached placenta lobule.

Blockage of the external pharynx of the cervix, inflection of the uterus and other wisdom relate more to theory. With normal contractility, these factors do not matter. A person with the same success exhales air, regardless of whether he has his own jaw or a false one. So the contents of the uterus freely leave its cavity during muscle contraction.

Infection

postpartum infection often a continuation of the process that began during pregnancy. Infection in sterile conditions is impossible.

Postpartum endometritis develops after transferred chorionitis - inflammation of the membranes. Affected by inflammation inner surface uterus does not respond to oxytocin stimulation. The uterus becomes flabby, contractions become sluggish.

Causes of subinvolution of the uterus come to light in maternity ward and treated in a hospital setting.

After childbirth, the organic structures of a woman undergo significant changes, and if the delivery was by caesarean section, then rehabilitation takes a longer time. Of particular concern in many patients is the uterus after a caesarean section - is the recovery proceeding correctly, are there any deviations, etc.

Postpartum rehabilitation period called the period of time that is spent on the restoration of the body in connection with the changes caused by pregnancy and subsequent childbirth. Postpartum recovery lasts about one and a half to two months. The only exception is the breast, because lactation begins a couple of days after birth, then the mammary glands reach their maximum functionality.

Immediately after cesarean, ice is placed on the patient's stomach so that the uterus begins to contract better, as well as to prevent uterine bleeding. The woman is kept in the ward for the first day intensive care, controlling its pressure and intensity of uterine secretions, the condition and size of the uterus, general well-being etc. In the first three days, the puerperal woman can be given painkillers, and if necessary, transfusion of blood components, etc.

To avoid possible infectious lesions the puerperal is prescribed antibiotics, which are administered before caesarean, 12 hours later and after a day after the operation. After a few hours, patients can already get up. You can walk after 6 hours if there were no complications during and after surgical delivery.

Common problems after cesarean

The most common problems after a caesarean are:

The uterus can recover for a long time to its previous size, so sometimes it needs a little help and stimulate its contraction.

Condition of the uterus after surgical delivery

After a delivery operation, the uterus can remain in a stretched state for quite a long time, which is not at all surprising. During this period, it is more like open wound, and rather large sizes (10-12 cm). But over time, the endometrial layer heals, and the organ itself noticeably shrinks. After surgical delivery uterine muscles, nerve endings and vascular structures are damaged, which increases the duration of organ involution. If hypotension is observed, then the muscles cannot recover on their own, so the woman is prescribed injections of drugs that reduce the uterus.

The processes of uterine contraction after cesarean under the influence of some factors can noticeably slow down. Especially often this happens due to polyhydramnios or weakened labor activity, benign tumor processes or multiple pregnancy, against the background of inflammatory lesions of the ovaries or uterus. It also affects contractility and temporary restriction of mobility, because the first time after a cesarean, a woman is often forced to be under droppers. And in the future, movements are limited to painful sensations arising from postoperative suture.

Features of the restoration of the uterus

How quickly the uterus will contract is determined by several factors. If the cesarean was planned in advance, during the operation there were no complications and additional surgical procedures, then it will take about two months to restore the uterine body. Moreover, the contraction will proceed spontaneously, without additional impact on the uterus.

If the delivery operation proceeded with some deviations or any complications were found in the woman, then additional stimulation of contractile uterine activity may be required through the introduction of special medications. In addition to improving contraction, these funds help stop bleeding from damaged uterine vessels.

During the entire pregnancy, the size of the uterus increases by almost 500 times, so it takes a certain time to restore it. And in the case of a caesarean section, in addition to stretching, there is also incised wound, which only complicates the recovery processes, which come down to three aspects: discharge, healing of the suture and reduction to the original parameters.

What kind of discharge

In the process of recovery, the lochia changes noticeably, by their nature one can even judge the degree of rehabilitation of the patient.

At first, after a surgical delivery, the mother has bloody-mucous discharge, which disturbs for about a week. The color of such lochias is rich red, there are noticeable clots.
But gradually the discharge will lighten and after a few weeks it will resemble brownish menstrual smears.

Mommy should not force things, because too quick cessation of discharge (before 6 weeks) is usually considered by doctors as a deviation that requires an additional examination of the patient. If the uterine discharge is observed for too long (more than 9 weeks), then a gynecologist's consultation is also necessary.

Both quickly stopped and too prolonged discharge are equally dangerous for a woman. They can lead to purulent processes inside the uterus, the development of endometritis and other pathological complications.

Seam condition

Another indicator of uterine recovery is the healing of the postoperative suture. Today, surgeons perform dissection in several ways: classical, transverse or vertical. A classic incision is made vertically at the apex of the uterus. There are many vessels in this zone, so such an incision is accompanied by heavy bleeding, which is why doctors rarely use this technique.

Vertical incision is performed for premature delivery or abnormal uterine development. The most preferred is a transverse incision, which is located on the lower fold of the abdomen, almost above the pubis. Such a dissection is characterized by less blood loss and trauma, reduces the likelihood of postpartum infection and does not heal as slowly as other types of incisions. After healing, such a scar does not affect future pregnancies and allows a woman to give birth naturally.

When performing a suture on the uterus, doctors use self-absorbable sutures like vincryl, dexon, etc. In the early days, a bandage is applied to the scar every day, and the suture itself must be processed to avoid inflammatory complications. After about a week, a scar will form, then the woman in labor will be able to wash herself in the shower. To speed up the healing of the seam, a woman is recommended to wear special bandage shorts or a belt.

How long does the uterus contract

It is difficult to say how long the contraction of the uterus will last. Every woman is different, and clinical picture the recovery period after operative delivery also depends a lot. According to research, after cesarean uterus weighs about a kilogram, but after a week it becomes half as much, after two weeks the uterus decreases to 350 grams, and after a three-month postpartum period it will return to its original parameters.

The uterus contracts most actively in the first 14 days, although the entire recovery period takes several months. The contraction is indicated by pulling and cramping pain in the uterine region. If the pain is too unbearable, then the woman is prescribed antispasmodic medications. If the uterus does not contract or contracts too slowly, then such symptoms may indicate the development of complications, so a gynecological examination is necessary.

Also, a delayed uterine contraction can be the result of physiological abnormalities in the development of the organ (kinks, bends, underdevelopment, etc.), inflammatory diseases, fibrous tumors or traumatization of the birth canal. In such situations, the duration of uterine recovery will be determined by the appropriate treatment.

What contributes to the reduction

To improve contractile uterine activity, patients are prescribed medications such as prostaglandins, Oxytocin. But there are a lot of home methods that will make the uterus contract much faster:

Do not forget about hygiene standards, timely processing the seam, otherwise purulent-inflammatory complications may begin, which will only prolong postpartum recovery.

Options for postoperative complications

If the period of contraction stretched out for a rather long period, then the cause of this may be a blockage of the uterine pharynx, as a result of which the lochia accumulate inside the organ and cannot naturally come out. In such a situation, a woman is prescribed curettage or curettage, when the accumulated remnants are removed from the uterus mechanically. Such a measure is necessary, otherwise there is a high risk of developing inflammation leading to sepsis, endometritis and other complications.

If a woman has lost a lot of blood during a caesarean section, this can lead to weakness and uterine hypotension, which is why there is practically no contractile activity. Adhesive pathology can also complicate the delivery operation, which leads to impaired mobility and prevents the contractile activity of the uterus, i.e., causes the development of uterine subinvolution.

Danger signs

In the maternity hospital, specialists monitor the puerperal every day, but after being discharged home, the woman does not have time to listen to her own condition, because she plunges into new life mothers. In such situations, often anxiety symptoms remain unrecognized, leading to serious complications. Therefore, you should definitely contact a specialist if:

Uterine discharge is abnormal or did not stop 2 months after surgery. Normally, bloody lochia are allocated only in the first postpartum week, after which their character changes to serosanguineous. Closer to day 20 postoperative period the discharge becomes liquid and light, after which it disappears altogether.
opened uterine bleeding. A similar condition may indicate remnants of foreign tissue in the uterus or hypotension, in which the uterus does not contract well. To stop bleeding and determine its cause, medical intervention is necessary.

The main thing is not to try to solve the problem at home and folk ways. Various tinctures and decoctions can be used as additional therapeutic agents, but with such a complication as bleeding, they can only do harm.

When can you get pregnant again

Concerning sexual relations, then after cesarean, you can start them no earlier than 2 months later. A similar period is set if the delivery took place without any deviations. Otherwise, observance of sexual rest is extended for certain period. If a woman wants to give birth again, then this will become possible only after a couple of years, when complete healing and scar formation on the uterine wall. Therefore, during this period, it is necessary to responsibly approach the issue of contraception. It is recommended to combine mechanical barrier means with oral contraceptives.

If pregnancy does occur, doctors recommend doing medical abortion, because the chances of bearing and giving birth to a viable baby do not exceed 10%. Therefore, a woman needs to be responsible for the issue. postoperative rehabilitation and medical advice. After all, a cesarean is a full-fledged abdominal operation that can cause many complications and undesirable consequences.

After the birth of a child, serious changes occur in the body of a young mother, which are mostly localized in the uterus. long time after childbirth reproductive system women are back to normal. Recovery of the uterus takes at least several months. At this time, it is necessary to follow the rules of daily hygiene and visit the gynecologist on time to avoid possible complications.

Not every woman can give birth naturally. Nowadays, the number of young mothers who gave birth to their child by caesarean section is steadily increasing. Such childbirth is no longer considered difficult, doctors perform surgery using partial or complete anesthesia. But after the birth of a baby in this way, a young mother will need more patience, because the uterus recovers longer after a cesarean section than after a physiological birth.

After childbirth, the uterus becomes larger in size, and its inner layer looks like a whole bleeding wound surface. The bottom of the uterus has a diameter of 10 cm, immediately after delivery it is located 5 cm below the navel. Constant contractions of the muscle layer of the organ gradually lead to a decrease in its volume and restoration of the mucous layer.

Uterine contractions immediately after childbirth cannot be called strong, on the contrary, muscle fibers contract too little. And the type of childbirth does not play any role. Gradually, the contractility of the reproductive organ increases, but uterine contractions after cesarean section will still be weaker. Therefore, it takes longer to recover. Total duration postpartum period after caesarean section is two months. At this time, lochia comes out of the female genital tract - bloody discharge from the uterus.

During a surgical intervention associated with an incision in the muscular layer of the uterus, the vessels, nerve endings and muscle fibers lose their integrity, so the organ cannot contract as quickly as after natural childbirth. If the involution of the uterus after caesarean section is extremely slow, the doctor may prescribe specific drug therapy to the woman in labor.

Types of sutures on the uterus after caesarean section

During surgery on the abdominal wall and uterus, the doctor makes a transverse or longitudinal incision. Subsequently, the tissues in this place are scarred, a scar is formed, which does not always have an aesthetic effect. appearance. In addition, cicatricial changes after surgery, if the rules of care are violated, can become a source of serious complications, for example, provoking infections of the reproductive organs.

For sutures in medicine, materials of synthetic and natural origin are used. There are self-absorbable materials that do not require removal. In other cases, it is customary to remove the sutures on the 6th day after the operation. Quality suture material, as well as its quantity and surgical technique directly affect the rate of organ recovery and how the suture will look in the future.

Internal seams are superimposed directly on the wall of the reproductive organ. on the uterus after caesarean section requires special strength and compliance with all conditions for its subsequent healing. Usually the physician inseam uses self-absorbable materials.

Depending on the method of incision, the seams are of the following types:

vertical - superimposed down from the navel to the pubic region with an appropriate vertical incision;
transverse - superimposed along the bikini line, called the Joe-Kohen laparotomy;
arcuate - the incision is made in the area of the skin above pubic bone, is called the Pfannenstiel laparotomy.

As a rule, when planned operation doctors practice Pfannenstiel laparotomy. The seam superimposed on the incision will have cosmetic properties, that is, after healing, it will soon become difficult to distinguish on skin. In addition, such a suture on the uterus after cesarean section heals faster and more successfully, and blood loss after childbirth will be minimal.

At emergency operation, When we are talking there is no time to think about saving a mother or a child, about aesthetics. The doctor performs a longitudinal dissection of the reproductive organ and then puts strong interrupted sutures on it. This seam cannot be called aesthetic, but it has its advantages - it is produced quickly.

Recovery of the uterus after caesarean section

Whatever the birth, every woman in labor needs peace and rest. In the first hours after the woman stays in the ward under constant control from medical staff. The suture after the operation is systematically treated with antiseptics and the dressings are changed, and the appearance of signs of divergence of the suture on the uterus after cesarean section is monitored.

An ice bubble is applied to the lower abdomen of the woman in labor, since the cold is a stimulator of muscle contractions of the uterus and reduces the likelihood postpartum hemorrhage. The patient is also given drug therapy, whose tasks are pain relief and restoration of the digestive organs.

Resume after operative delivery sexual life recommended not earlier than after two full months. Planning for the next pregnancy can be done one and a half years after the operation. The scar on the uterus will be formed completely one year after cesarean.

After discharge from the maternity hospital, a woman is recommended to visit a gynecologist for an ultrasound examination and subsequent monitoring of the restoration of the reproductive system. In this case, the doctor must select a suitable contraceptive for the patient, since conception and pregnancy during the healing of the suture on the uterus after cesarean section is unacceptable.

In the future, when planning a new pregnancy, a woman should undergo hysterography - an x-ray examination of the uterus in several projections, and hysteroscopy - a visual examination of the genital organ using an endoscope from the inside.

These procedures allow you to assess the condition of the uterine scar and its possible behavior in future pregnancies. They are also necessary when it comes to the development of uterine fibroids after cesarean section. These manipulations can be carried out 8 months after the birth of the child.

Any physical activity is prohibited within 2 months after childbirth. Weight lifting, physical education and sports - everything is banned. With overstrain of the muscle fibers of the abdominal press, a divergence of the suture on the uterus after a cesarean section is possible, which prevents the normal healing of the postoperative scar.

Success postpartum recovery uterus after caesarean section is directly related to the characteristics of the course of pregnancy, the age of the woman, her state of health and the technique of performing surgical intervention.

Possible complications after caesarean section

Operational deliveries are surgical operation so complications may vary.

Surgical complications:

trauma of the bladder, intestines;
damage to parametrium, vascular bundles;
injury to the presenting part of the child;
hematoma after caesarean section on the uterus;
sewing to the uterus of the bladder;
internal or external bleeding.

Anesthetic complications:

Mendelssohn's syndrome - aspiration of the respiratory tract;
portocaval syndrome;
failure of tracheal intubation.

Postoperative complications:

subinvolution of the uterus after caesarean section (violation of its contractility);
purulent-septic conditions: endometritis, peritonitis, sepsis;
vein thrombosis, thrombophlebitis;
adhesive process, characterized by adhesions between various bodies abdominal cavity.

Most often, childbirth performed by surgery is complicated by massive blood loss. Of course, bleeding cannot be avoided with any type of childbirth. But if during natural delivery a woman can lose no more than 400 ml of blood (of course, provided that no complications arise), then during operative delivery this figure reaches 1000 ml.

Such blood loss is due to extensive damage vascular wall uterus, which occurs during the incision during the operation. If a woman loses more than 1 liter of blood, then most likely she will need an urgent transfusion. In 8 situations out of 1000, massive blood loss results in resection or removal of the uterus. In 10 out of 1000 cases, women need the help of an intensive care team.

As for lochia, which are normally removed from the uterus within a few weeks, the following symptoms should alert a woman:

If there was discharge after the operation, but suddenly disappeared after a few days, you need to urgently inform the doctor about this. This complication may occur because the cervix is closed after a caesarean section due to spasm, or its cavity is filled with blood clots, preventing the normal cleansing of the organ. congestion in reproductive organ can cause reproduction pathogenic microflora and cause endometritis and sepsis - the most severe consequences of childbirth.
If lochia go longer than 2 months and become more abundant, you need to call emergency care. Most likely, the uterus after childbirth could not contract in the right amount, and there was a possibility of hypotonic bleeding.

Do not be afraid of operative childbirth, if the doctor insists on their conduct - by his actions he tries to prevent Negative consequences and sometimes save the life and health of a woman and her child. next pregnancy it is better to plan no earlier than 2 years after the surgical delivery, providing the body with enough strength and opportunities for rehabilitation.

Useful video about re-birth after caesarean section

After a caesarean section, the mother's uterus recovers somewhat more slowly than after a normal birth. This is due primarily to the fact that caesarean is still abdominal surgery, which is not natural for the body, but rather, on the contrary, traumatic. So, during surgery, blood vessels, muscle fibers, and nerve endings are damaged. After the procedure, the uterus has a scar, which requires a certain amount of time and special care to heal.

How long the uterus can contract after a cesarean depends on many factors. With a planned operation and the absence of any complications, in order for the woman’s body as a whole and the uterus, in particular, to come to a satisfactory condition, it takes no less than 2 months, that is, almost the entire postpartum period. With a good outcome, the reduction process occurs by itself. However, in some cases, the appointment of drugs is required that would stimulate this process to go a little faster. These drugs have a stimulating effect on contractile activity, and also have a hemostatic effect on damaged vessels.

In general, the process full recovery The body of a woman after a caesarean section takes about two years. Why so long, you ask? Do you know that during pregnancy female uterus increased almost 500 times? So your body will have something to work on.

In the meantime, when the uterus after cesarean is still quite stretched and is 10 to 12 cm in diameter, when the scar is still quite fresh, the woman feels some discomfort. It can be associated with pain in the incision area, fear and difficulty going to the toilet, coughing, rolling over from side to side, etc.

All these nuances are discussed and resolved with the doctor, whose mother is observed during the postpartum period.

As measures to help you more comfortably survive the postpartum period, in addition to medicines a woman is prescribed a diet that is acceptable both for her and for the baby, as well as wearing a special bandage that prevents tissues from further stretching at a time when effective physical exercise the woman is not up to the task yet. The first time, while the uterus has not yet contracted after the cesarean section, and the seam has not healed properly, a woman should get an assistant who unloaded her from housework, lifting weights, which can very significantly affect the quality and speed of the recovery process.

Is it possible to put a spiral on women after a caesarean section

While the uterus is contracting...

After a caesarean section, however, as after a normal birth, the uterus is one continuous bleeding wound. The greatest damage to the organ in this case is located at the site of attachment of the placenta and the incision area. There are still remnants blood clots and fetal membrane. For 3-4 days, the bulk comes out spotting(lousy). After that, the color of the discharge gradually becomes lighter, they acquire the character of an ichor (about the third week after the operation) and after 6-7 weeks should stop altogether. By this time, the process of regeneration of the epithelium ends.

How is everything going?

How long does the uterus shrink after a caesarean section? We have already said that in 9 months it increases almost 500 times. Immediately after childbirth or caesarean delivery, the body weight is 1 kg. A week later - already half less, that is, half a kilogram. After another 7 days - about 350 grams, and by the end of the third month, she will have to come to her prenatal size and weight.

Thus, we see that the uterus contracts most actively in the first days after childbirth. Further, this process gradually slows down.

Sometimes the period of uterine contraction is accompanied by cramping, pulling pains lower abdomen. As a rule, they are not a cause for concern and are not permanent. However, sometimes, especially after repeated births, these sensations can cause some inconvenience, and some women cannot lead a normal life due to pain syndrome. In this case, you should consult a doctor. Most often, such situations are resolved by the appointment of antispasmodic drugs.

Sometimes there are cases when the uterus does not contract or this process is too slow. Such situations can become harbingers of bleeding or other complications, which means that here you just need to seek help from a specialist.

If the contractile activity is too long?

What can affect the time of uterine contraction after caesarean section? First of all, it is worth mentioning about multiple pregnancy or big size fruit weight. At the same time, the uterus stretches more and, accordingly, the mother's body needs more time and effort for it to contract.

The contraction process can also be slowed down if the placenta was low, if the caesarean section was not planned, but due to weak labor, and also if the woman after childbirth leads a very passive lifestyle, moves too little. Among other things, you can not discount general state woman's health, her readiness for caesarean section, concomitant diseases (hyper- or hypotension, nephropathy, etc.).

Speaking about how long the uterus can contract after a cesarean section, one cannot but draw your attention to inflammatory processes, physiological features developments (such as an inflection or underdevelopment of the uterus), which, by the way, can cause the uterus to not contract at all. This is also possible in the case of an injured birth canal, the presence of fibrous formations in the walls of the uterus, inflammation of the appendages of the present or even the past, in violation of blood clotting or polyhydramnios that accompanied pregnancy. Then only timely and correctly prescribed treatment can affect the time required for uterine contraction.

The doctor should determine how normal the process of uterine contraction is going before discharge.

If he deems it necessary, mom will be prescribed drugs that stimulate contractility - oxytocin or prostaglandins.

Sometimes a massage of the fundus of the uterus is also prescribed, which is performed through the anterior wall of the peritoneum.

What else contributes to uterine contractions?

An excellent contraction stimulant is breastfeeding, during which oxytocin is also released. That is why, in order for the uterus to contract more actively, women who have given birth (here - cesarean) women are recommended to start breastfeeding their babies as often as possible. In some maternity hospitals, in the first days, mothers are given a rest, and antibiotics are also prescribed to prevent postoperative infections, and for these reasons, babies are on artificial feeding. Therefore, being aware of these issues, you can discuss such nuances with your obstetrician-gynecologist in advance.

An active lifestyle, in this case - ordinary walks in the fresh air - walking.

Similar physical activity not only helps to reduce the time of uterine contraction, but also is preventive measure for start adhesive process after surgical intervention.

In addition, in order for the uterus to contract better after delivery by caesarean section, women are advised to lie on their stomach more often, ideally (if the chest allows) - to sleep on it.

Also, take very seriously hygiene procedures, timely and correctly process the seam, preventing the penetration and spread of infections.

How long does it take for a scar to heal after a caesarean section?

An important factor affecting the normal contraction of the body of the uterus after cesarean section is the timely emptying of the bladder and the implementation of defecation. Often these are quite natural for healthy body processes deliver a woman who has given birth (whether on her own or by caesarean section) a lot discomfort. Nevertheless, these nuances are extremely important not only for the normal contraction of the uterus, but also for the functioning of other systems and organs, the recovery of the body after surgery in general. Unfortunately, many women are embarrassed by such problems and delay contacting a doctor. In no case should this be done in order to avoid problems in the future, to ensure good quality life for you and your baby. After all, healthy children most often grow up with healthy mothers.

If the uterus does not contract at all ...

There are times when the time of contraction of the uterus is too long and the woman experiences some discomfort and inconvenience. As a rule, this happens because lochia remains in the cavity, which should have gradually come out naturally. However, the cervix of the uterus may be blocked and this does not happen. Then doctors resort to cleaning (also called scraping), when the remnants of labor are removed mechanically.