home Audience 4 Symptoms of internal suture dehiscence after cesarean section. Suture on the uterus after cesarean section

Symptoms of internal suture dehiscence after cesarean section. Suture on the uterus after cesarean section

After gestation and birth of a baby, many very significant changes occur in the female body, but it is the uterus that experiences particular stress. After such a serious test, all organs and systems return to normal over a long period of time, but it is the uterus that released the baby into this world that needs special attention during the recovery process even after a normal natural birth. Uterus after caesarean section requires special attention and needs very careful care.

Uterus after surgical birth

That's all today more women due to the most various reasons give life to their children precisely through surgical intervention. Just 15-20 years ago, such an operation was an exception and was performed only in the most emergency cases, but today it is not complicated or unusual, and almost every second woman gives birth by cesarean section.

In this case, anesthesia can already be not only general with the use of full anesthesia, but also epidural, partial, when future mommy remains conscious and takes part in childbirth. But recovery after such a birth will take more than one month.

After the baby is born, the uterus is not only a continuous wound on its inner surface, but also shaped like a stretched sac; contractions that begin immediately after birth gradually bring the organ back to normal, returning the uterus to its original size and promoting healing of the internal part.

After a caesarean section, the uterus and its body cannot contract naturally or this process occurs very slowly, so the uterus needs help. The reason for this condition is usually the lack of natural labor activity, if the operation was planned, or its weakness - during emergency surgery.

As a rule, in the final part of the operation, after removing the baby and cleaning the uterine cavity, the doctor injects the hormone Oxytocin into the walls of the organ to stimulate the contraction process and avoid possible complications.

The process of recovery of both the uterus and the body as a whole after cesarean section is always much slower and more difficult, and postpartum period increases to 2 months, during which the woman must observe many restrictions so as not to harm herself. A full recovery occurs only after about 2 years.

The process of contraction of the walls of the uterus and its return to normal condition slows down also because the muscle fibers have been damaged (cut) and scar formation occurs in this place. It is the suture on the uterus after a cesarean section that is the reason for such a long and often painful recovery of the organ and the additional purpose of some medical supplies to speed up the process.

Bleeding after a cesarean section and the release of lochia continue, as a rule, much longer than after a natural birth, since not only the uterine cavity must heal inner surface, but also the vessels that were cut during the operation. For this reason, in the first month after a cesarean section, a woman in labor is prohibited from lifting any weights or engaging in any physical activity, especially those that create excess pressure on the abdominal area.

Discharge home from the hospital is possible only 7-8 days after the operation, and only if no complications arise after the intervention. At home, all responsibility for the condition and health falls on the woman herself, so it is very important to follow not only the special regime and all the doctor’s instructions, but also strictly monitor yourself, your hygiene and regularly treat the sutures.

For a year, and sometimes two, a woman may experience pain in the area of the uterus when bending over, sneezing or coughing, or when lifting something heavy. In some cases, such sensations accompany a woman after cesarean throughout her life.

Restoration of the uterus, possible complications

After any birth female body needs rest, recovery and full replenishment of strength, just like after any very hard work. Some might say that during Caesarean woman does nothing, she just lies there, not experiencing labor pains, severe pain, push, severe overvoltage the whole body, which means it cannot be called hard work and cannot be compared with the ordeal of natural childbirth.

But we should not forget that any operation causes a lot of consequences and difficulties for a person, requires many restrictions, and anesthesia has no effect on the body at all. positive action and can cause unpredictable consequences. Recovery after a cesarean section is always several times more difficult and longer than after a normal birth.

During the first 2-3 days, a woman after a cesarean section is in a special ward if everything went well, or in the intensive care unit if complications arise. In any case, she is constantly monitored by doctors who monitor all changes in her condition.

Immediately after the operation, a bubble with a piece of ice is placed on the incision area, which is necessary to prevent large blood loss and additionally stimulate the contractile process. In addition, it is necessary to appoint various drugs to relieve pain at the incision site and scar tissue, to further stimulate contraction, as well as products designed to restore the functioning of the intestines and the entire digestive system.

After being discharged home, it is important to especially carefully monitor your condition and follow all the rules of personal hygiene and suture treatment. It is important to maintain sexual rest, the period of which after cesarean section is about 2-3 months, but the doctor determines the exact period individually, based on the condition of the scar, which is assessed using ultrasound.

The second pregnancy (or subsequent) can be planned no earlier than 2-3 years after the cesarean section.

Today, medicine allows two cesarean sections with an interval of 3-5 years, although in some cases doctors allow a third pregnancy. Here everything depends on the condition of the uterus and the scars present on it, and this depends on how the recovery period and the pregnancy itself proceeded, whether the doctors’ instructions were followed. Great importance has both the woman’s age and her psychological readiness to possible complications and risks when repeat pregnancy.

The main complication can be called high level blood loss. If during a normal birth blood loss is about 300 ml, then during a cesarean section this figure can reach from 600 to 1000 ml, and the body will not be able to restore such a volume on its own.

For this reason, during the operation, the woman is infused with blood substitutes or natural blood products. Most of the possible complications are due to the fact that caesarean section is primarily a serious abdominal surgery, intervention in the abdominal space.

Therefore, among possible consequences There are also a number of common complications that arise after any operation, for example:

The method of cutting and stitching is important

There are several ways to cut the uterus, but today doctors use only three of them:

But, in addition to the method of incision, suturing is also of great importance. The site of uterine incision can be sutured with either a single-row suture or a double-row suture using special suture materials that do not require further removal, since they themselves dissolve internally within a few months.

Modern medicine has a sufficient selection of special surgical threads that greatly facilitate both the work of doctors and the period after surgery, since such threads do not cause rejection and do not lead to inflammation. But complete healing of the uterine scar and fusion of the cut tissues occurs only after a year.

The upper incision, located on the abdomen, today in most cases (for an uncomplicated operation) is simply sealed with a laser, after which there is practically no scar left in the future, but only a light strip on the skin. With a laser suture, a woman can be discharged home within 4-5 days, and the suture itself does not require constant and thorough treatment with subsequent removal of threads, as in the case of suturing a wound in the usual way.

But it is important to remember that no matter how the cesarean section is performed, no matter what suture is placed on the uterus and abdomen, the woman must follow all the doctor’s instructions and limit herself in many things, in particular, physical activity.

In the first month after surgery, any physical activity, especially if inadequate to the condition, is strictly contraindicated. Start putting your figure in order and perform simple exercises, which do not cause pain, are possible only 3-4 months after suturing.

One of the complications after a cesarean section is suture dehiscence. The external seam may come apart, and this will immediately become obvious, or the integrity of the internal seam may be compromised, and this can only be seen with the help of diagnosticians. A discrepancy can occur after the operation and years later, when the woman wants to feel the joy of motherhood again. In this article we will talk about why seams come apart, what to do if this happens, and how to prevent such a situation.

Inner and outer seams

During surgical delivery, the surgeon cuts not only the abdominal wall, but also the anterior wall of the uterus. Immediately after the birth of the fetus and removal of the placenta, each incision is stitched with its own stitches. For the seams inside and outside, various suturing techniques are used, as well as special materials.

When the operation is planned, most often a horizontal section is made just above the pubis (in the lower segment of the uterus). An emergency caesarean section can be performed by cutting the abdominal wall either horizontally or vertically, depending on how urgently the baby needs to be removed.

When forming an internal suture, the surgeon has no room for error - the edges of the wound must match as accurately as possible. Even a slight displacement can lead to the formation of a rough and incompetent scar. Threads for suturing the uterus are usually self-absorbing; these sutures do not need to be removed or processed later. Most often, the uterus is sewn with a single-row continuous seam.

External seams can be stitched. Materials for external seam can be different - silk surgical threads, self-absorbing threads, medical alloy staples. Recently, a number of clinics have been practicing new method soldering the seam with liquid nitrogen, that is, without using threads at all.

External stitches can be cosmetic or regular. The first ones then look more aesthetically pleasing. If speak about external seams, then the horizontal section according to Pfannenstiel is always more preferable, since the probability of its divergence is much lower than with the corporal section (vertically from the navel to pubic area). Horizontal external sutures heal better than vertical ones.

The healing process takes place in different ways. Internal sutures on the uterus take about 8 weeks to heal. After this time, the long, almost two-year formation of a strong and reliable scar begins. If this process is not interfered with negative factors, he will be quite strong and can easily withstand bearing the next child and even in some cases physiological childbirth in the most natural way.

If more coarse material is formed during formation connective tissue, then the scar may be insolvent. This will pose a risk of divergence in the future if the woman becomes pregnant.

The external suture takes a little over a week to heal, after which the sutures are removed if they are not self-absorbing. A vertical suture after a corporal cesarean section takes about 2 months to heal and requires more careful care.

Types of violation

All problems with the condition of the seam can be divided into early and late. Early ones are those that make themselves felt in the coming days or weeks after surgery. Late problems include problems that are significantly distant in time from the moment of surgical intervention.

Early complications may be:

bleeding from the external suture area;
internal bleeding;
formation of hematomas in the area of scars;
inflammatory process (both internal and external);
divergence of the internal or external seam.

Late complications– this is the formation of fistulas, hernias and divergence of the uterus along the scar during next pregnancy or during childbirth.

Reasons for the discrepancy

There are quite a lot of reasons that can lead to divergence of seams both inside and outside, but the leading place is given to violation of the recommended rehabilitation period mode. So, both external and especially internal seams can suffer due to improper motor activity postpartum women.

It is recommended to get up after surgery only after 8-10 hours, but some try to do this earlier, which leads to early injury to the sutured areas. Inaccurate attempts to stand up and sit down after surgery, and subsequently ignoring the requirement to limit lifting weights to 3-4 kilograms are the main reason why the seam came apart.

Infection may also be the cause of postoperative suture separation. Both the internal and external wound surfaces may become infected. In general, infectious complications after cesarean section are among the most dangerous and most likely, despite the sterility in the operating room and technological progress. Inflammation or suppuration disrupts the process of fusion of the wound edges, which may well result in a violation of the integrity of the suture.

Another reason, not the most common, but very likely - immune reaction the woman’s body onto the surgical material with which the sutures are applied. It is generally quite difficult to understand immunity, and therefore you can never say in advance whether sutures, especially internal self-absorbable ones, will take root. If the immune system begins to reject them, an inflammatory process will inevitably begin, which will lead to a violation of the integrity of the scar. A certain negative immune reaction may also occur to external suture material.

The cause of the disorder internal seams There may also be too active contractions of the uterus after surgery. But hypertonicity reproductive organ It is quite rare after surgery.

Signs and symptoms

There are usually no issues with identifying problems in the condition of an external seam. The area where the threads are applied is red, hematomas may be observed, ichor or blood oozes from the wound, and pus may be discharged. In this case, the body temperature usually rises. The suturing area hurts, the seam “burns”, it pulls, it bothers you even in a lying position. The discrepancy itself is manifested by the formation of a hole of a certain size (depending on how many stitches did not take root or were torn off as a result of inflammation or mechanical trauma).

It is more difficult to understand that there are problems with the inner seam. In this case, the picture will be somewhat blurry and similar to a number of other complications after surgery. But experienced doctor first of all, he will suspect the discrepancy of the scars and check these suspicions using certain diagnostic methods.

If there are problems with the healing of the suture on the uterus, the woman will keep heat. Discharge from the genitals will be much more abundant than after a normal uncomplicated operation; large fragments may be present in it suture material. General state the pregnant woman will rapidly deteriorate. Decreasing arterial pressure, episodes of loss of consciousness and rapid heartbeat may occur. Skin become pale, sweating increases.

The appearance of bumps on the external scar area cannot be ignored. This can be either a hernia or a fistula, if the bumps themselves are filled with pus and ichor.

Divergence during re-pregnancy

The danger of a suture after a cesarean section on the uterus lies in the fact that it may not withstand the next pregnancy and will separate. The risks of discrepancy especially increase when:

pregnancy that occurred too quickly after the first operation (less than 2 years have passed);
incompetent heterogeneous internal scar;
large fruit.

To monitor the stretching of the internal scar on the uterus during pregnancy, a woman repeatedly undergoes an ultrasound to determine the thickness and areas of thinning of the internal suture. But, alas, it is impossible to stop the uterine rupture that has begun.

The danger of such a discrepancy is quite obvious - the death of the fetus and its mother. Moreover, the woman dies from massive bleeding in abdominal cavity, and the fetus - from acute sudden hypoxia, which occurs due to disruption of the uteroplacental blood flow at the time of uterine rupture.

The first stage, the stage of a threatening rupture, cannot be felt in any way. She has no symptoms, and only a specialist ultrasound diagnostics able to detect this condition. In this case, the woman undergoes an emergency caesarean section.

The onset of rupture of the suture on the uterus is characterized by sharp abdominal pain, and the development of painful shock is possible. Blood pressure drops, tachycardia appears. The baby's normal heart rate suddenly slows down.

The completed rupture may be accompanied by the development of severe, heavy bleeding. If this happens during childbirth, if a woman decides to give birth with a uterine scar on her own, then an emergency caesarean section is also performed. In most cases the uterus is removed.

How to behave in such cases?

Considering the seriousness of the situation, if any problems with the stitches are detected, the woman should immediately report them to the doctor. If problems are discovered in the maternity hospital, the woman’s temperature rises and becomes more abundant. postpartum discharge, there are signs of trouble with the external scar, then you cannot hide this from the medical staff. The woman will be helped. If the problem is detected at home, after discharge, the woman needs to take horizontal position, call an ambulance and wait for the brigade to arrive. You should not go to clinics and antenatal clinics on your own, as the discrepancy may increase, and if we're talking about about the inner seam, the clock counts.

When calling the ambulance, you need to inform that that you suspect scar divergence and describe in detail your current state of health. This is important, because in this case, an obstetrician on duty will definitely be included in the medical team.

Infectious lesions sutures are usually treated with antibiotics, both systemically and locally. If there is an internal discrepancy, the woman is given surgery to apply new sutures or remove the uterus if it is not possible to close the rupture.

If a rupture of the internal scar is detected at any stage during a subsequent pregnancy, it cannot be prolonged. A delivery operation is performed. If a child is very premature, he, alas, may not survive. If a woman is brought late to medical institution, unfortunately, she may not survive either.

Prevention

Stitch problems are easier to prevent than to treat. Considering the seriousness of the consequences of postoperative suture dehiscence, a woman must strictly follow the recommendations after a cesarean section:

lifting weights is strictly prohibited, the limit is 3-4 kg for at least six months;
you cannot squat, fall, or jump sharply, you should not pump your abs until six months after the operation;
after discharge outer seam needs to be treated every day - dry with hydrogen peroxide, lubricate the area around it with brilliant green;
Before removing the sutures, it is imperative to wear a surgical bandage on the wound; after removal, the decision to wear it is made individually, depending on the condition of the suture;

To learn how to care for a suture after a caesarean section, watch the following video.

Childbirth by caesarean section is now perceived as a routine procedure. However, the application surgical method does not pass without consequences. After a caesarean section there is always a scar on the uterus. Women do not remember about it until the moment when they decide to get pregnant again, because... For doctors, uterine scarring is one of the indicators of a favorable pregnancy outcome.

What is a uterine scar? What does he look like? How will another pregnancy proceed after a caesarean section?

What is a scar, why does it appear after a cesarean section, what is its normal thickness?

During a caesarean section, the surgeon removes the baby from the uterus. To do this, he needs to make incisions in the peritoneum and reproductive organ. After the baby is removed, the damaged areas are sutured.

A scar is a formation that forms during the healing process of tissue at the site of injury. The uterus is held together with special materials that can dissolve after some time. First, a superficial connection of the edges of the organ occurs. After a few months, the tissues grow together, the damaged area becomes denser, and a scar forms.

It consists of two types of tissue: muscle and connective. Muscle fibers give the uterus elasticity. The connecting elements help to hold the injured area together. The basis of the bonding tissue is collagen, which provides a denser fusion structure. It is because of this element that scars appear.

Scar formation goes through several stages. At the first stage, a film forms at the incision site and the area turns red. Further, the fused tissues darken, and when completely healed, they lighten. The scar on the uterus is finally formed 6-12 months after the operation, and strengthens only after 2 years.

Gynecologists monitor the healing process of the uterus and determine the thickness of the formation. The most dense and elastic scars are formed with a transverse incision of the uterus. After longitudinal surgery, inelastic tissue predominates in the scar, as a result of which it becomes rough and fragile.

Normally, the thickness of the formation should be more than 5 mm. A thin scar does not affect the well-being and health of a woman. However, if she wants to give birth to a child, then such a scar will cause complications.

Possible pathologies and their symptoms

This article talks about typical ways to solve your issues, but each case is unique! If you want to find out from me how to solve your particular problem, ask your question. It's fast and free!

The process of scar formation on the uterus is influenced by various factors:

the body's ability to regenerate;
uterine inflammation (endometritis, endometriosis);
edge bonding technique;
cutting methods;
type of material for stitching.

The listed factors can lead to scar failure. An education with the following indicators is called insolvent:

thickness - less than 5 mm;
the main tissue is connective;
formation of a niche in the seam;
fusion has different size in various areas.

The photo shows a scar with a formed niche. Failure leads to complications that affect the woman’s health. Greatest danger represents uterine rupture as it enlarges during pregnancy.

If the seam is thin or its fabric has lost elasticity, then reproductive organ stretches unevenly. The incision site experiences increased stress and is damaged.

Uterine rupture leads to heavy bleeding, dangerous to the life of the fetus and mother. Also, if the suture fails, inflammation often develops in the areas where niches are formed. Inflammatory process provoked by menstrual fluid accumulating in the formed cavities.

However, even with a normal scar structure, pathologies may manifest during the next pregnancy:

Securing the placenta close to the birth canal. If the uterus has an integral structure, then during pregnancy the placenta can rise higher. However, the existing scar prevents this process. Low presentation leads to premature birth.
Attachment of the fertilized egg to the scar. At the seam, the fabrics have an inferior structure. They cannot provide the embryo normal nutrition. Such pregnancies in most cases end in spontaneous abortion.
Delayed fetal development. Some scars affect blood circulation in the uterus. When it is violated, the child does not receive enough necessary substances and oxygen.
Fusion of the placenta with the uterus. If ovum is located close to the suturing site, the placenta can adhere to the reproductive organ. Incrementation sometimes leads to removal of the uterus.

Depending on the type of pathology, a woman feels various symptoms. Characteristic symptoms presented in the table.

Complication	When is it detected?	Symptoms
Failed scar	Most women do not know about the presence of pathology until another pregnancy occurs.	painful sensations when touching the scar; discomfort when urinating or defecating; bleeding after sexual intercourse; strong uterine tone during pregnancy.
Uterine rupture	During pregnancy	dizziness, nausea, vomiting; blood discharge from the genitals; sharp pain in the lower abdomen; uterine tension; pale skin; a sharp decrease in blood pressure; changes in fetal behavior.
Niche formation	Any time	menstrual irregularities; abnormal menstruation; pain in the pelvic area; nausea.
Incorrect attachment of the placenta	During pregnancy	hypertonicity of the uterus; pain in the perineum; red or brown discharge.
Placenta accreta to the uterus	During childbirth	the placenta does not come out; postpartum bleeding.

Diagnostic studies of the scar after cesarean section

The first examination of the suture is carried out 6 months after surgery. Diagnostics are also prescribed when planning pregnancy and during pregnancy. Diagnosis is carried out using the following methods:

Palpation of the uterus. The gynecologist feels the outline of the genital organ to determine the size of the scar and the woman’s reaction to touching the site of damage to the uterus.
Hysterography. The procedure is carried out using an X-ray machine. Before the examination, they inject into the reproductive organ contrast agent. Hysterography allows you to identify the location of the uterus, its shape, and the structure of the scar. It is not performed during pregnancy.
Hysteroscopy. The examination is also prescribed before the child is conceived. During the examination, a special device is inserted into the cervix. The procedure allows you to determine the appearance, size of the scar, and the amount of connective tissue in the area of fusion.
MRI of the uterus. Helps to identify its ability to stretch during pregnancy, the condition of the uterine scar, the presence of niches and unevenness of fused tissues.
Ultrasound. The study is carried out to determine the condition of the uterus during pregnancy. Ultrasound allows for early detection of uterine damage.

Pregnancy and childbirth with a scar on the uterus

For a successful pregnancy after a cesarean section, it is necessary for the scar to become stronger. Optimal time For re-gestation, a period of 2 to 4 years after the operation is considered. 2 years are enough for the formation of strong tissues, but after the 4th year the scar begins to lose elasticity.

Early or late pregnancy can lead to uterine rupture. After a caesarean section, experts do not welcome unplanned conception, since in order to determine the capabilities of the uterus it is necessary to conduct a preliminary diagnosis of the scar.

If the scar is strong and elastic, then the gestation process does not have distinctive features. The only thing that will distinguish a pregnant woman after a cesarean section from other expectant mothers is the need to do ultrasounds more often.

It is considered normal if by 38 weeks of pregnancy, due to tissue stretching, the scar site becomes thinner to 3 mm. Experts recommend against repeat pregnancy in the following situations:

Less than 1.5 years have passed since the operation;
the scar consists mainly of connective tissue;
multiple or large niches were found on the formation;
seal thickness is less than 3 mm.

Repeated births after cesarean section most often also end with surgery. However, recently more and more specialists prefer to give a woman the opportunity to give birth on her own. Natural childbirth is possible if the following conditions are met:

the recommended fusion periods are observed;
one baby is expected;
the cervix is not damaged;
age expectant mother- up to 35 years;
there are no violations of the structure of the reproductive organs;
the fetus has taken the correct position;
child's body weight - no more than 3.5 kg;
the incision during the previous operation was longitudinal;
muscle fibers predominate in the suture tissues;
scar thickness - at least 5 mm.

Treatment of uterine scar

Although previously this was considered sufficient dangerous operation, Caesarean section is now often used during pregnancy and childbirth. Although the operation itself is safe because it is always performed only by qualified doctors, its consequences can harm the woman’s health. Most often this happens due to the fact that the suture has come apart after a cesarean section.

Types of sutures after cesarean section

Caesarean section as an operation consists of two stages. The first is an incision to access the muscular frame, and the second is an incision to access directly the uterus. Accordingly, after it there are two seams left - internal and external. But operations are also divided according to the type of external incisions:

Horizontal cut. Typically, this type of incision is used during a planned operation. As a rule, self-absorbable threads called catgut are used to apply such sutures, and the scars after them heal quite quickly, with a minimum of traces.
Vertical cut. This type of incision is usually used if any complications occur during childbirth. It allows for easier passage of the baby and ensures normal delivery. In terms of healing, such an incision is less comfortable due to the inability to use a self-absorbing thread, as well as the scar remaining after the operation.

Thus, after a cesarean section, a woman is left with two stitches: one on the uterus, and the second on the anterior abdominal wall. Both seams, if you do not follow the doctor’s recommendations during the rehabilitation period, may separate. But it is the internal discrepancy that is considered the most dangerous. Moreover, the risk of this happening is quite small - only fifteen percent.

Rupture of threads in the abdominal cavity

Another complication that women who have undergone a cesarean section may encounter is the divergence of the threads in the abdominal areas. The external suture heals quite quickly after a cesarean section, but despite this, it can still be damaged. Most often this is caused by physical exertion or failure to sterilely process the threads. The edges of the wound should be regularly cleaned using sterile cotton swabs or swabs. It is important to be careful when doing this, as incorrect movement can result in tearing of the seams.

Also, in the area of the incision, separation of the abdominal muscles after a cesarean section can occur due to wearing tight, compressive clothing. This is due to the fact that the muscle corset has not yet strengthened after the operation. The muscles cannot withstand the same tension as before surgery, so tight clothing causes the threads at the seams to break.

Dehiscence of the suture on the uterus after cesarean section

The most severe complication What can happen after surgery is a rupture of the uterine suture or internal suture. This most often happens to women during their second and subsequent pregnancies that end in caesarean section. This is due to the fact that scar tissue is less well supplied with blood than normal tissue. Therefore, in a place that has been recut and healed, tissue density is lower and ruptures occur more often. The most common causes are physical activity and heavy lifting. Also, a gap can occur due to a short break between pregnancies. Doctors recommend taking a break for at least three years.

There are usually three types of violation of the integrity of the suture after surgery:

Threatening uterine rupture. An asymptomatic injury that is usually detected only through .
The old seam begins to tear apart. Symptomatically expressed by pain in the suture area and symptoms inherent in painful shock: cold sweat, pressure drop, tachycardia.
Uterine rupture. Includes symptoms of the previous complication, as well as severe abdominal pain and bleeding.

Symptoms of seam dehiscence

Most often, the symptoms of seam dehiscence are quite noticeable, they are immediately felt and bring severe discomfort, pain. During the period, which usually lasts about two weeks, and if necessary individual characteristics even longer, pain persists at the suture site. But if it does not disappear or weaken after this period, this is a reason to consult a doctor.

It is also worth paying attention to vaginal discharge. They usually begin to appear immediately after surgery. In case of any damage to the seam, their number quickly increases. They may also be red in color. This is very dangerous signal, indicating that the patient needs urgent health care. Also, the discharge consists of two parts - liquid and lochia.

Do you have symptoms of seam dehiscence?

YesNo

They protect the mucous cavity from infection and viruses and are removed regularly. If they stop being released, this indicates that they have entered the abdominal cavity, which can lead to infection.

Another symptom is the development of inflammation of the suture. It usually becomes noticeable as the temperature rises. This symptom may signal a small discrepancy in which other symptoms are mild.

Signs

If the integrity of the seams is violated, the signs of divergence are usually similar. But the problem here is that it is very difficult to predict the possibility of such damage. To avoid problems, a woman needs to be under constant supervision by a doctor who will record changes in her condition.

When a suture on the uterus diverges after a cesarean section, there are usually three degrees of disruption of the integrity of the scar: threatening damage, the beginning of divergence, and complete divergence of the sutures on the uterus. The most main danger The point is that the first stage of damage, threatening uterine rupture, does not make itself known in any way; it can only be determined by ultrasound. That is why after the operation the patient needs to undergo diagnostics for some time in order to be absolutely sure of the integrity of the suture, even if she is not bothered by any pain symptoms.

The onset of discrepancy is usually characterized by increased pain in the area of the operation and symptoms similar to painful shock: cold sweat and tachycardia. A rupture of the uterine wall that occurs is an extremely dangerous injury. Statistically this is the most common reason death of mother and child. They can only be saved if urgently surgical intervention.

However, sometimes damage to the uterus is not accompanied by any symptoms at all. That is why it is very important to constantly monitor the condition of the woman in labor after the operation in order to avoid problems in the future.

Prevention of scar dehiscence

As with any surgical procedure, a postoperative recovery period is indicated after a cesarean section. Although it is not very large for this particular operation, it is important to follow all the doctor’s instructions, because neglecting them can lead to serious complications. The main points to remember are:

Prohibition on lifting heavy objects. Any physical activity after surgery can cause the suture to simply come apart. It is not even recommended to pick up a child, which is usually prohibited by doctors in the first days after surgery.
It is important to treat sutures and take antibacterial drugs.

These rules should never be neglected, because any violation threatens to lead to rupture of the walls of the uterus, which is an extremely serious and dangerous injury that can even lead to death.

In addition, the seam may become inflamed. It is also necessary to follow all the rules and sterility of suture care at home:

You can use special ointments and gels to speed up healing. Levomekol and Panthenol help a lot, accelerating the healing of external sutures. Can also be used sea buckthorn oil and milk thistle oil.
You also need to remember about hygiene. If necessary, a sterile bandage must be applied to the seams, which must also be done with clean hands.

Attention! Before using any ointments, consult your doctor!

Scar ointment

How long does it take for a stitch to heal?

Complete scarring internal suture usually occurs on the seventh day after surgery. To avoid possible complications, the threads from the outer seam are removed at the same time. If self-dissolving catgut is used, it remains in the wound in small “pieces” for 70-80 days until completely dissolved.

After this, a week later, discharge usually occurs. Usually, possible complications during the healing process of the suture at this stage are prevented by carrying out normal hygiene measures. Usually, if the wound does not bleed and no discharge comes out of it, then the procedures are limited to a simple change sterile dressing. The suture heals quite quickly; after complete healing, cosmetic surgeries can also be performed to make the scar more attractive appearance. You can do the same, this is another one good way hide traces of the operation.

What to do if the stitch breaks after a cesarean section

But what to do in a situation if the seam breaks or some other damage to the scar occurs?

During recovery, you may experience various problems, but most of them still require medical intervention:

Bleeding. If the wound begins to ooze bloody issues, then it must be treated, and then consult a doctor.
Inflammation. If the wound begins to become inflamed, this may indicate infection.
Suppuration. The accumulation of pus in the wound may indicate infection in a vulnerable area. To prevent its spread, the doctor installs a drainage to get rid of the pus.
Discrepancy. After the muscles are pulled apart during surgery, they are held together with sutures. One of the most frequent complications their divergence due to loads is considered.

Most main advice to the question “What to do if the stitch breaks after a caesarean section” - do not panic. From stress, the body itself can aggravate the situation, so you just need to seek medical help in time and eliminate the problem.

Doctors' opinions in emergency situations

Because caesarean section is a very common operation, the greatest risk arises not during its implementation, but during postoperative recovery. This is due to the risk of complications that occur under a variety of circumstances. Another problem is that almost all injuries that appear after surgery require medical attention. That is why doctors urge you to follow the doctor’s recommendations after discharge to avoid possible complications.

In the case of one of the most frequent damage– when the suture comes apart after a caesarean section, you should promptly contact medical assistance. In such a situation, there is a high risk of wound damage or infection. If you have concerns or suspicions about internal injuries, you should seek help immediately, especially if this is your second pregnancy and the patient has already had a cesarean section, because if complaints are ignored, the consequences can be catastrophic.

At the first sign of infection in the wound, you should also immediately go to the doctor. Inflammation or suppuration can lead to infection of the entire body, which is dangerous for the life of the mother in labor. In most cases, you should not try to help yourself on your own - due to the lack of the necessary knowledge and skills, you may not only fail to help, but also harm yourself.

Conclusion

Caesarean section carries several dangers during the healing period. Due to the risk of suture dehiscence after cesarean section, you should refrain from physical activity on certain period, and to protect the rumen from bacteria, it is necessary to maintain impeccable hygiene postoperative suture. But at the same time, wound damage after surgery is usually quite rare, and is not particularly common. serious injuries, like an internal seam tear. Such a pathology occurs only in five percent of all cases, and timely medical care saves from it, as well as from its consequences. But at the same time, throughout the entire period of wound healing, a woman must carefully follow all the doctor’s recommendations. Although neither postoperative period, a woman should not be afraid of the operation itself - operations are carried out with painkillers, and during recovery pain syndrome stopped by certain medicines. However, you need to be warned to be aware of possible problems and prevent them in time.

The suture on the uterus after a cesarean section may come apart both soon after the operation and during the next birth.

Types of sutures after cesarean

The “classic” option is a longitudinal or vertical section. In modern practice, it is abandoned because it takes longer to heal and has a greater likelihood of suture rupture in the future. Today they resort to a vertical cut in the most emergency, if there is a threat to the life of the baby or mother, and childbirth must be carried out as quickly as possible. A longitudinal incision allows you to quickly remove the baby and avoid danger.

The second type is a transverse or horizontal cut. It is carried out horizontally in the lower part of the uterus, heals faster, and has a low probability of suture dehiscence in the future - from 1% to 6%.

How long does it take for a stitch to heal after a cesarean section?

The healing time of sutures is mainly individual and depends on many factors: health status, compliance with hygiene rules and postoperative behavior, etc.

The type of suture also affects: if a transverse incision was made during the operation, the suture heals on average about six weeks, if longitudinal - about eight.

Thus, the average healing time for sutures after a cesarean section is six to eight weeks. But the stitch may hurt longer. It can make itself felt even after a few months or a whole year.

Reasons why sutures on the uterus may come apart

The sutures on the uterus may come apart during postoperative recovery if the woman in labor does not follow the recommendations given to her by the doctor. In this case, the cause of the rupture may be physical activity (sports), heavy lifting (if the mother lifts the stroller alone, carries heavy bags from the store).

In addition, the suture on the uterus may come apart during the next pregnancy. This could happen like later gestation and during the birth process itself. In this case, the suture rupture is caused by an insufficiently long interval between births (you can give birth without the risk of rupture at least three years after a cesarean operation), the woman’s age (after 30, the elasticity of the tissue is lost, the risk of rupture increases), and a vertical suture. In addition, rupture can occur due to medical fault.

Also, the risk of uterine suture rupture during childbirth increases if drugs were used to induce labor.

Symptoms of uterine suture dehiscence

Determine the suture rupture on the uterus by external signs very difficult. It is usually accompanied by pain in the suture area, and vaginal bleeding is possible.

If a rupture occurs during a second pregnancy, the baby's heartbeat changes.

You can diagnose a suture rupture in the uterus using ultrasound, as well as experienced specialist may detect it in time during childbirth.

Possible consequences

If during childbirth or pregnancy the doctor detected a rupture of the suture on the uterus in time and took appropriate measures, the risk is minimal.

Otherwise, uterine rupture may result horrible consequences - death for the baby or for the mother. But statistics say that this happens extremely rarely.

How to protect yourself from seam splitting

Follow all doctor's recommendations after surgery: during recovery period Avoid physical activity, do not lift heavy objects.

Don't plan new pregnancy earlier than three years after cesarean section.

At sharp pain And vaginal bleeding consult a doctor immediately.

If you are going to give birth again and are planning natural childbirth, give Special attention suture during an ultrasound scan.