What do lochias look like. Sexual life during lochia. Purulent nature of postpartum discharge

After the baby is born, the placenta separates from the uterus, which provokes the rupture of numerous vessels that connected them together. This is how bleeding is formed, along with which the remnants of the placenta, already dead particles of the endometrium and some other traces of the intrauterine life of the fetus come out.

Such discharge after childbirth in medicine is called lochia. None of the newly-made mothers will be able to avoid them. However, there are a number of questions they raise. How more woman will be aware of their duration and nature, the less risk of avoiding complications that often occur against the background of such postpartum "menstruation".

Particular attention during this period should be paid to personal hygiene. To avoid possible infections and an unpleasant smell, because a girl always wants to remain attractive, she should be very careful and attentive to the washing cosmetics that you use.

The choice of hygiene products should always be treated more carefully and do not neglect reading the composition. After giving birth, your body goes through a period of adaptation and recovery, and therefore many chemicals can only aggravate the condition and prolong recovery period. Avoid cosmetics that contain silicones and parabens, as well as sodium laureth sulfate. Such components clog the body, penetrating into the blood through the pores. It is especially dangerous to use such products during breastfeeding.

To be calm about your own health and the health of your child, as well as to always remain beautiful and attractive, use washing cosmetics only from natural ingredients, without dyes and harmful additives. Leader in natural detergents cosmetics remains Mulsan Cosmetic. abundance natural ingredients, a formulation based on plant extracts and vitamins, without the addition of dyes and sodium sulfate - makes this cosmetic brand the most suitable for the period of breastfeeding and postpartum adaptation. You can find out more on the website mulsan.ru

Each female body is very individual, and the timing of its recovery after the birth of a child is also different for everyone. Therefore, there can be no unambiguous answer to the question of how long the discharge after childbirth lasts. However, there are limits that are considered the norm, and everything that goes beyond them is a deviation. It is on them that every young mother should be guided.

• Norm

The norm established in gynecology postpartum discharge is from 6 to 8 weeks.

• Tolerances

They range from 5 to 9 weeks. But such a duration of discharge after childbirth should not be reassuring: despite the fact that doctors consider this a slight deviation from the norm, it is necessary to pay attention to their nature (quantity, color, density, smell, composition). These descriptions will tell you exactly whether everything is in order with the body or it is better to seek medical help.

• Dangerous deviations

Lochia should be alert, the duration of which is less than 5 weeks or longer than 9. It is imperative to detect when the postpartum discharge ends. It is equally bad when it happens too early or too late. Specified terms indicate serious disorders in the body of a young woman that require immediate laboratory testing and treatment. The sooner you see a doctor, the less dangerous will be the consequences of such prolonged or, conversely, short-term discharge.

You need to know! Many young mothers are happy when their postpartum discharge is over within a month. They feel like they've gotten away little blood and can enter into the usual rhythm of life. According to statistics, in 98% of such cases, after some time, everything ends with hospitalization, because the body could not be completely cleansed, and the remnants of postpartum activity caused inflammatory process.

Deviations from the norm can be acceptable and dangerous. But anyway they can have serious consequences for the health of the young mother in the future. Therefore, every woman should monitor how long the discharge after childbirth lasts, comparing their duration with the norm established in gynecology. If in doubt, it is better to consult a doctor for advice in a timely manner. Much depends not only on how many days they last, but also on other, already qualitative characteristics.

Lochia composition

To understand whether everything is in order with the recovery of the body after childbirth, a woman should pay attention not only to the duration of lochia. Sometimes it fits into the norm, but their composition leaves much to be desired and may indicate serious problems.

Fine:

• the first 2-3 days after childbirth there are spotting due to bursting blood vessels;
• then the uterus will begin to heal, and open bleeding will no longer be;
• usually in the first week you can observe discharge with clots - this is how the dead endometrium and the remnants of the placenta come out;
• after a week there will be no more clots, the lochia will become more liquid;
• no need to be scared if you observe mucous discharge after childbirth - these are the products of intrauterine vital activity of the fetus;
• mucus should also disappear within a week;
• 5-6 weeks after the birth of the baby, the lochia become similar to the usual smears that occur during menstruation, but already with coagulated blood.

So bleeding after childbirth, which frighten many young mothers, are the norm and should not be a cause for alarm. It is much worse if pus begins to mix with them, which is a serious deviation. You should consult a doctor if the composition of lochia differs in the following characteristics:

• purulent discharge after childbirth indicates the onset of inflammation (endometrium), requiring immediate treatment, its cause is infectious complications, which are most often accompanied elevated temperature, while lochia is distinguished by an unpleasant odor and a greenish-yellow color;
• if mucus and clots continue to go longer than a week after childbirth;
• watery, transparent lochia is also not considered the norm, because it can be a symptom of several diseases at once: it is a fluid from the blood and lymphatic vessels that seeps through the vaginal mucosa (it is called a transudate), or it is bacterial vaginosis - vaginal dysbacteriosis, which is characterized by abundant discharge with an unpleasant fishy smell.

If a woman knows which discharges after childbirth are considered normal, depending on their composition, and which ones indicate abnormalities, she will be able to seek advice and medical help from a gynecologist in a timely manner. After passing tests (usually a smear, blood and urine), a diagnosis is made and appropriate treatment is prescribed. To understand that not everything is in order with the body will also help the color of lochia.

The color of postpartum menstruation

In addition to the composition of lochia, it is imperative to pay attention to what color they are. Their shade can tell a lot:

• first 2-3 days normal discharge after childbirth, they are usually bright red (the blood has not yet coagulated);
• after that, brown discharge occurs within 1-2 weeks, which indicate that it is happening without deviations;
• the last weeks of the lochia should be transparent, slight turbidity with a slight yellowish tint is allowed.

All other colors of lochia are deviations from the norm and may indicate various complications and diseases.

yellow lochia

Depending on the shade, yellow discharge can indicate the following processes taking place in the body:

• pale yellow, not very abundant lochia may begin by the end of the second week after childbirth - this is the norm and should not cause concern for a young mother;
• if bright yellow discharge mixed with greenery and putrid smell went already 4 or 5 days after the birth of the baby, this may indicate the onset of inflammation of the uterine mucosa, which is called endometritis;
• if after 2 weeks there is a yellow discharge, a fairly bright shade and with mucus, this is also most likely a symptom of endometritis, but it is not so obvious, but hidden.

It is useless to treat endometritis on your own, at home: it requires serious treatment antibiotics, and severe cases held surgical removal damaged inflamed uterine epithelium to cleanse the mucosa in order to give the upper layer of the membrane the opportunity to recover faster.

green slime

Endometritis may also indicate green discharge, which are much worse than yellow ones, because they mean an already launched inflammatory process - endometritis. As soon as the first droplets of pus appear, even if only slightly greenish, you should immediately consult a doctor.

White discharge

It is worth starting to worry if white lochia has gone after childbirth, accompanied by symptoms such as:

• bad smell with sourness;
• curdled consistency;
• itching in the perineum;
• redness of the external genitalia.

All this points to sexual urinary infections, yeast colpitis or vaginal candidiasis (thrush). In the presence of such suspicious symptoms, it is imperative to contact a gynecologist so that he takes a swab from the vagina or a bacterial culture. Once the diagnosis is confirmed, appropriate treatment will be prescribed.

black bleeding

If black discharge occurs in the postpartum or lactation period, but without any additional symptoms in the form of an unpleasant, pungent odor or pain, they are considered the norm and are dictated by changes in the composition of the blood due to restructuring hormonal background women or.

Helpful information . According to statistics, women mostly turn to gynecologists after childbirth with complaints about black discharge, which scares them the most. Although in fact the most serious danger represents the green color lochia.

Red color

Lochia should normally be red only on initial stage in the first few days after the baby is born. The uterus during this period is an open wound, the blood does not have time to clot, and the discharge acquires a blood-red, rather bright shade. However, after a week it will change to a brownish-brown color, which will also indicate that healing occurs without deviations. Usually, the discharge becomes cloudy gray-yellow, closer to transparent, a month after childbirth.

Every young woman who has become a mother should clearly and clearly understand what color the discharge after childbirth should be normal, and what shade of bad will give her a signal that she needs to see a doctor. This knowledge will help you avoid many dangerous complications. Another characteristic of postpartum menstruation may alert during this period - their abundance or scarcity.

Number of selections

The quantitative nature of the discharge after childbirth can also be different and indicate either a normal recovery of the uterus, or some deviation from the norm. From this point of view, there are no problems if:

• go in the first week copious discharge after childbirth: the body is thus cleansed of everything unnecessary: ​​blood vessels that have done their job, and obsolete endometrial cells, and placental remnants, and intrauterine fetal life products;
• over time, they become less and less: meager discharge, starting from 2-3 weeks after childbirth, is also considered the norm.

A woman should be alerted if too little discharge is observed immediately after childbirth: in this case, the ducts and pipes could become clogged, some kind of blood clot could form, which prevents the body from getting rid of postpartum debris. In this case, you should definitely consult a doctor and undergo an appropriate examination.

Even worse, if abundant lochia does not end for too long and go for 2-3 weeks, or even more. This suggests that the healing process is delayed and the uterus cannot fully recover for some reason. They can only be found out during a medical examination, and then eliminated through treatment.

Smell lochia

Women know that any discharge from the body has specific smell which can only be eliminated through proper hygiene. In the postpartum period, this characteristic of lochia can do a good job and report problems in the body in time. Pay attention to how the discharge smells after childbirth.

• In the first days they should come with the smell of fresh blood and dampness, after this time a shade of mustiness and charm can be observed - in this case this is considered the norm.
• If there is postpartum discharge with an unpleasant odor (it can be putrid, sour, pungent), this should alert. Together with other deviations from the norm (color, profusion) this symptom may indicate inflammation or infection of the uterus.

If you think that postpartum discharge smells very bad, do not hope that this is temporary, will pass soon, or is the norm. In order to avoid complications, the most correct decision in this case would be to consult a doctor at least for a consultation.

Break in secretions

It often happens that the discharge after childbirth ended and started again after a week or even a month. In most cases, this causes panic in young mothers. However, such a break does not always indicate deviations from the norm. What could it be?

1. If scarlet, fresh spotting has started 2 months after childbirth, it can be either (in some women the body is capable of such a quick recovery, especially in the absence of lactation), or rupture of the sutures after heavy physical or emotional stress, or some other problems which can be identified and eliminated only by a doctor.
2. If the lochia has already stopped, and then suddenly returned after 2 months (for some, this is possible even after 3 months), you need to look at the qualitative characteristics of the secretions in order to understand what is happening with the body. Most often, this is how the remnants of the endometrium or placenta come out, which something prevented from leaving immediately after childbirth. If the lochia is dark, with mucus and clots, but without a characteristic putrid, pungent odor and in the absence of pus, most likely, everything will end without any complications. However, in the presence of these symptoms, we can talk about an inflammatory process, which is treated either with antibiotics or through curettage.

Since a break in postpartum discharge may indicate the presence of an inflammatory process in the uterus, do not delay visiting a doctor. After the examination, he will accurately establish whether this is a new menstrual cycle or a deviation from the norm that requires medical intervention. Separately, it is worth paying attention to lochia after.

Lochia after caesarean section

Those who have had a caesarean section should understand that the nature of the discharge after an artificial birth will be somewhat different. Although this will concern only their duration and composition. Here are their features:

• body after caesarean section restored in exactly the same way as after natural childbirth: blood and dead endometrium come out with secretions;
• in this case, there is a greater risk of catching an infection or inflammatory process, so you need to special attention regularly carry out hygiene procedures;
• in the first week after artificial birth, bloody discharge is abundant, with the content of mucous clots;
• normally, the color of lochia in the first days should be scarlet, bright red, and then change to brown;
• the duration of discharge after artificial childbirth is usually delayed, since the uterus in this case does not contract so quickly and the healing process takes a long time;
• it should be borne in mind that blood after a cesarean section should go no more than 2 weeks.

Every new mother should understand how important role plays into her health full recovery uterus after childbirth. How it passes can be understood by lochia. It is necessary to track their duration, the timing when the discharge stops and starts again, their qualitative characteristics. There can be no accidents here: color, smell, quantity - each symptom can be a timely signal for visiting a doctor, identifying a problem and undergoing appropriate treatment.

After childbirth, any woman has specific secretions from the genital tract. They occur regardless of the method of delivery - naturally or through surgery. They can last for a different time, have a different color, character or smell. You need to know how long the discharge after childbirth lasts, what character they have different time after the birth of a baby, how to recognize signs of abnormalities. Any doubt should be a reason for consultation with a gynecologist.

Postpartum discharge from the genital tract - natural process. At the final stage birth process from uterine wall the placenta departs, which was previously closely connected with the inner surface of the organ and is permeated with blood vessels that carry blood to the fetal body. Under it is an open wound surface, which begins to bleed. This becomes the source of lochia. Gradually, the vessels of the former placental site become empty, contract, and become covered with a new layer of endometrium. Normally, the discharge continues for 6 weeks, a maximum of 2 months.

Lochia

Lochia have a different origin than menstruation, and differ from them in color, volume and duration. In it is necessary to pay attention to the color and consistency of the discharge, as well as the absence or presence of an unpleasant odor. A timely visit to the doctor with any questions about this can not only save health, but also save the life of the mother.

Lochia appear as a result of the fact that after the separation of the placenta, the vessels connecting it and the wall of the uterus remain open and blood is released from them. It enters from the uterine cavity through the open cervix into the vagina.

Postpartum lochia consists of the following components:

• exfoliated endometrium (inner uterine lining), which thickens significantly during pregnancy;
• blood and ichor from the uterine wall, to which the placenta was attached;
• dead and necrotic tissue;
• mucus and blood released from the healing cervix;
• parts of the fetal membranes and epithelium of the fetus.

Lochia is not menstruation and is not controlled by hormonal changes. After childbirth will take place some time before the pituitary gland, hypothalamus, ovaries begin their regular activity and recover normal cycle. For breastfeeding mothers, the first menstruation occurs about six months after childbirth. If the child is on artificial feeding, menstruation can resume after 6 weeks (read more about the timing of recovery of menstruation after childbirth).

IN rare cases menstrual-like weak bleeding is noted already a month after the birth of a newborn. They are easily confused with ending lochia, but at this time a woman can already become pregnant.

Less intense postpartum lochia is observed in preterm birth, and stronger than normal - with multiple pregnancy and after surgery.

The first hours after

As soon as the placenta is born, a gradual contraction () of the uterus begins. This effect is enhanced by the attachment of the newborn to the breast. Often, an ice pack is placed on the stomach of a woman in labor, this is necessary to prevent severe bleeding.

The volume of blood loss in the first hours should not exceed 500 ml. At this time, there is a bloody nature of postpartum discharge mixed with clots and mucus. This removes the remains of the placenta and amniotic membranes from the uterus.

In the first hours, the patient may feel an unpleasant odor of the released blood. This is largely due to the influence of the hormonal background. In the blood, the level of oxytocin and prolactin increases, which increase the sensitivity of olfactory receptors. In the normal course of early postpartum period the woman is transferred to the department in 2-3 hours.

First days

At first, there is an intensive release of lochia. The neck is not yet completely closed, and the uterine wall is still a wound surface. This creates prerequisites for the development of postpartum endometritis. To prevent infection, all hygiene rules must be followed. If the nature of the discharge changes, you must immediately inform the gynecologist about this.

What should be the normal discharge after childbirth:

• In the first 4 days, lochia is a mixture of blood clots, parts of the membranes, meconium, decidua, and discharge from the cervical canal. Painful abdominal cramps, reminiscent of menstrual pain, caused by intense uterine contractions, may be felt.
• During the 1st week, the lochia are colored in a rich dark red color, they are quite thick, they have an admixture of mucus, there may be lumps or clots. During the application of the child to the breast, the intensity of their release increases. This is a normal process of cleansing the birth canal.
• A woman should be prepared for the fact that when getting out of bed, she can stand out at once a large number of blood. Therefore, it is recommended to stock up big amount special hygiene products, as well as oilcloth for the bed.

Duration spotting normally up to 7 days. If they last more than a week, or opens uterine bleeding, or large blood clots depart, this may be a sign of a retained part of the placenta in the uterus. This condition often leads to the development of an infection and requires immediate medical attention.

To speed up the separation of lochia, the prone position is recommended, as well as the use of a postpartum bandage. He supports internal organs, preventing the uterus from taking on an incorrect position that contributes to blood retention in it, for example, bending to the side or backwards.

First month

After 7 days, the wound surface begins to become covered by the endometrium. The uterus has already contracted quite well, although it is still above the womb. During the 2nd week, the number of lochia gradually decreases. Discharge from the genital tract changes color from red to darker, brown, an unpleasant odor is normally absent.

If in the first days of the postpartum period a woman had to change her sanitary pad every 2 hours, now one pad can be used for 4-5 hours. Washing with warm water and soap is recommended before each change of hygiene product.

After 10 days, the discharge acquires a yellowish tint. It contains fewer red blood cells and more white blood cells, cervical mucus, serous fluid.

How long do these discharges last?

This stage lasts about 3-4 weeks.

Allocations a month after childbirth are observed in most women. However, their intensity is reduced so much that a woman can use daily pads. Their character is slimy, without foreign inclusions and smell. If the lochia lasts more than 6 weeks, you should consult a doctor.

The uterus at this time is already returning to normal size, so abdominal pain or increased discharge during feeding of the child are not observed. At the end of the month, the cervical canal is completely closed, which blocks the path of a possible infection.

Every woman goes through the postpartum period differently. It is considered normal if the discharge persists for 6-8 weeks. They can end earlier - by the end of 4-5 weeks.

For caesarean section

The operation is accompanied by additional damage to the uterine vessels, so the bloody discharge after such childbirth during the first 7 days is more intense. Its color and consistency correspond to the norm. Further purification process the uterus is coming according to physiological parameters. After a maximum of 2 months, any vaginal discharge should stop.

Changes in the amount of discharge

Most common causes this is the retention of parts of the placenta inside the uterus or the attachment infectious process. In this case, such deviations from the norm are possible:

1. A small amount or premature termination may be associated with a mechanical obstruction to the outflow of intrauterine discharge. This is usually a large blood clot covering internal os cervical canal. Blood can accumulate in the uterus and when it is in the wrong position as a result of subinvolution. The likelihood of such a complication increases with abnormalities in the structure of the uterus, various neoplasms (cysts, tumors).
2. Abundant outflow of mucous fluid may be a sign of perforation (perforation) of the uterine wall, for example, with the failure of postoperative sutures. Abundant lochia are also observed in violations of blood coagulation. Such a sign can be a symptom of life-threatening conditions and requires immediate medical attention.

Any pathological changes must be eliminated as quickly as possible. Some of them require drug treatment, while others require scraping or surgical intervention.

Changes in the nature of the discharge

Postpartum recovery is individual, but there are common features characteristic of the normal course of the postpartum period or pathological abnormalities.

• Light yellow discharge

Characteristic of the final period, it replaces brown spots and gradually brightens to a completely colorless mucus. Saturated yellow discharge can signal the onset of an inflammatory process in the uterus. They appear as early as 4-5 days and are accompanied by soreness in the lower abdomen, and also have an unpleasant putrefactive odor. The cause of this condition is endometritis, trauma to the wall or cervix. Yellow lochia can also appear when the cervical canal is blocked, when blood cannot be released from the uterus, and the putrefactive process begins. Another reason is ruptures of the cervix and vagina, complicated by inflammation.

• Greenish discharge

Normally not observed. They indicate inflammation of the inner wall of the uterus -. It is often caused by bacterial infection, which is caused by poor contractility of this organ. As a result, lochia lingers in the uterine cavity, an inflammatory process begins with the formation of greenish pus. Purulent discharge is a reason for immediate consultation with a doctor. The disease is often accompanied by fever, abdominal pain, weakness, and an unpleasant smell of discharge from the genital tract. Left untreated, it can cause infertility or blood poisoning.

• brown discharge

Normally, they appear at week 2, replacing bright red, and at the end of the second week they gradually brighten. If the brown color persists for more than a month, the cause of this may be an inflammatory process (endometritis), fibroids, bending of the uterus, reduced blood clotting. Copious dark brown discharge in the early postpartum period indicates incomplete separation of the placenta and requires urgent medical intervention - curettage of the uterine cavity.

• Mucous discharge

Starts on the 3rd week and gradually moves into the usual for a healthy non-pregnant woman. Earlier appearance of mucus may be a sign of internal damage to the cervix, vagina. Abundant flow of mucus is an important sign. This condition requires urgent medical attention.

• Prolonged bloody or pink discharge

They are a sign of hypotension of the uterus associated with its excessive stretching or weakness of the wall. Another reason for prolonged weak bleeding is the presence of placental remnants in the uterine cavity. Pink fluid may appear as a result of a bleeding disorder, excessive physical activity and early sexual intercourse. Sometimes on the 21-28th day, the first menstruation appears this way.

• White discharge

Most often caused, while they have sour smell, and small light clots are determined in them. Candidiasis does not pose a threat to life, but delivers a lot discomfort, for example, itching in the perineum. Therefore, it is necessary to consult a doctor and choose a safe breastfeeding antifungal therapy.

Hygiene

Lochia is a physiological phenomenon, they are necessary for the cleansing of the uterus and its healing. During them, it is important to observe hygiene rules:

1. Need to stock up in advance sanitary pads and change them regularly. In the early days, you will need products with high absorbency.
2. Tampons should be avoided menstrual cups this increases the risk of infection.
3. It is recommended to avoid sexual contact during the first 6 weeks.
4. At this time, physical exercises and significant loads should be abandoned.
5. In the first month, you can not swim in the pool or pond.
6. It should be regularly washed with warm water and soap, while the movements should be directed from front to back. It is not recommended to use perfumed products for intimate hygiene, it is best suitable baby soap.
7. It is recommended to urinate regularly, even in the absence of pronounced urges. This will help prevent the spread of infection from the urinary tract.

Stop using blood thinners like aspirin and increase your iron intake at the same time.

Lochia- This is a physiologically determined postpartum discharge from the uterus, consisting of mucous exudate, an admixture of a small amount of blood and fragments of a decidua that has lost its viability. In fact, postpartum discharge from the uterus can be considered a wound secret. When lochia leave the uterus and go outside, they already contain cervical mucus and fluid contents of the vagina. Such accompanying "impurities" can affect appearance and lochia consistency.

Postpartum lochia manifest the beginning of involution - the normal process of returning the uterus to its original, prenatal state. The number and color of lochia changes as the uterus restores its previous size, the tone of the muscle wall and the healing of the inner mucous layer. The complete disappearance of lochia against the background of the physiological postpartum period means the completion of the recovery phase.

To have a correct understanding of the mechanism of the appearance of lochia, it is necessary to understand the essence of the physiological and anatomical changes female body during the period of preparation for childbirth and after their completion.

The uterus, acting as reproductive organ, It has complex structure, allowing her to endure and give birth to a child, and after childbirth return to its original state. The wall of the uterus consists of several layers that perform a specific function:

- The outer, serous, layer (perimetry) that performs the function of protection is part of the peritoneal cover. From the uterus, it smoothly passes to neighboring organs.

- A thick and incredibly powerful muscle layer (myometrium) is represented by several types of muscle fibers arranged in a spiral, as well as elastic fibers that strengthen them. The structure of the myometrium is unique, because the uterus increases in size many times over during the period of gestation, and during childbirth it is able to push the child out using the mechanism of muscle contractions.

- The inner mucous layer lining the uterine cavity (endometrium). It is a hormone dependent tissue. Under the "control" of estrogens, cyclic structural changes occur in the endometrium. In the first half menstrual cycle the endometrium increases in volume, sprouting new blood vessels. After ovulation, if it has not occurred, the amount of estrogen decreases, and the changes in the mucosa that have occurred are eliminated: the overgrown mucosa begins to be shed, and during the period of menstrual bleeding, the entire “unnecessary” part of the endometrium leaves the uterus and expires.

Once pregnancy occurs, the endometrium continues to grow to fertilized egg plunged into it and fixed well. For normal growth, nutrition, respiration and excretion of fetal metabolic products in the uterus, the placenta is formed - a temporary additional organ. It is attached to the uterine wall, literally growing into the loose endometrium at a place called the "placental site", and is connected to the fetus through the umbilical cord. The placenta independently, like a hormonal gland, synthesizes progesterone, which reduces the tone of the uterus and prevents.

In pregnant women, the outer, functional, layer of the endometrium, which is cyclically rejected outside of pregnancy, for correct formation and bearing the fetus turns into the so-called decidua, lines the entire inner surface of the uterus, surrounding the fetus.

In childbirth, increased contractions of the muscles of the uterus initially push the fetus out, and then free the uterine cavity from the placenta.

Thus, after childbirth and separation of the placenta, decidual tissue, liquid and thrombosed blood, destroyed muscle cells, and mucus remain in the uterus, and there is an extensive wound surface at the placenta attachment site. All this uterine contents are gradually evacuated to the outside in the form of postpartum secretions - lochia. Epithelialization of the damaged epithelium in the uterus occurs simultaneously with the rejection of the decidual tissue and is completely completed by the tenth day after birth. Damage to the endometrium in the area of ​​the placental site heals much more slowly. The endometrium fully acquires its original appearance only after six weeks, and at the same time, postpartum lochia should stop.

Lochia is a normal postpartum discharge signifying the process of cleansing and healing. inner surface uterine cavity. Their presence should not cause concern if they gradually decrease in number and disappear 3-6 weeks after birth. The color of the lochia should also gradually change from bright red to almost transparent.

Lochia after childbirth

As already mentioned, lochia appear immediately after childbirth and continue until the uterus completely returns to the "prenatal" state and restores its epithelial layer. Postpartum discharge got its name in ancient times, when they were considered for “postpartum cleansing”, and their presence was interpreted as cleansing the body of “impure” blood in the veins that appeared as a result of pregnancy. However, in fact, lochia cannot be only a uterine secret, since after the expiration from the uterus, they attach the discharge of the cervical canal and the contents of the vagina.

How physiologically it proceeds can be judged by the color and amount of postpartum discharge. Abundant red lochia is usually observed in the first two or three days after childbirth, and after ten days they can become slimy and scanty.

Lochia appear after childbirth in all those who have given birth, but their nature and duration vary considerably and depend on the course of childbirth and the postpartum period. That is, lochia directly depends on the process of involution of the genital organs.

So what happens to the genitals in the postpartum period?

After the birth of the placenta, due to a sharp contraction of the uterine muscles, the uterus significantly decreases in size, acquiring the shape of a ball. However, the ligaments that support the uterus cannot contract quickly like the myometrium, so they remain stretched longer and cause increased uterine mobility.

The cervix is ​​significantly injured when the fetus moves along it. Its walls are greatly overstretched and become very thin, the mucosa is torn, the external pharynx opens wide, and the cervical canal freely passes the hand into the uterine cavity. The postpartum cervix is ​​like a thin-walled bag with torn edges hanging down into the vagina.

The most intensive involution of the uterus occurs in the first two days after the birth of the fetus. A few hours after childbirth, the tone of the pelvic and vaginal muscles is restored, and they pull the uterus up, and a day later the size of the uterus is reduced by half.

It is possible to control the recovery period and its pace by determining the localization of the uterine fundus, which is palpated directly through the anterior abdominal wall. The doctor puts the edge of the palm on the stomach and, gently pressing, probes the uterus. Behind diagnostic criterion the position of the bottom of the uterus relative to the conditional horizontal line passing through the navel is taken. As you progress involutionary processes the uterus quickly falls below this line, and at the end of the period of complete recovery, it is localized behind the womb. It is difficult to determine the exact size of the uterus and the rate of its involution by palpation; if necessary, a more accurate diagnosis is carried out ultrasound scan. It also allows you to see the structural changes occurring in the endometrium.

From the inside, the surface of the uterus after the end of childbirth is similar to an extensive wound, the most pronounced destructive processes in the area of ​​the placental site. A significant amount of blood may be present in the uterine cavity, as well as blood clots. The lumen of the exposed uterine vessels narrows sharply after childbirth, the blood coagulates and forms blood clots to stop bleeding, so the first two days of bloody lochia may contain small clots.

Muscles are involved in the process of uterine involution, connective tissue and myometrial vasculature.

The healing of the inner layer of the uterine wall begins with the collapse and subsequent rejection of fragments of the decidual tissue, and with it, blood with clots and other rejected destroyed tissue structures. Similar postpartum discharge is lochia.

Within six weeks, about 500 - 1500 ml of lochia expire from the uterine cavity. The first two days there are bright red abundant lochia. Then, when the vessels stop bleeding and thrombose, the nature of the discharge gradually changes. Three days later, bright bloody lochia are replaced by darker, brownish-red discharge. Brown lochia manifest stop bleeding in the uterus. They are replaced after a week. yellow lochia, which gradually become slimy and light.

Only a doctor can determine the true nature of atypical postpartum discharge, and laboratory research helps to establish their microbial and cellular composition.

How long does lochia last

The duration of lochia has no clear criteria. It depends on many factors:

- weight and size of the fetus;

- the volume of amniotic fluid (they also stretch the uterus);

- the number of children born;

— concomitant pathology(for example, a chronic infectious process);

- the state of the blood coagulation system and immunity;

- the presence of complications in childbirth and after them;

- method of delivery (through the birth canal or surgical).

early start breastfeeding stimulates the rate of involution of the genital organs after childbirth and reduces the period of lochia.

The average values ​​of the duration of postpartum discharge were determined:

- In the first two days, lochia is like menstrual bright red discharge. They are dominated by erythrocytes.

- On the third and fourth days, the amount of fresh blood in the discharge from the uterus decreases, the lochia becomes darker, acquire a brown-red hue. Brown lochia is due to the fact that the vessels in the uterus no longer bleed, and there are a lot of leukocytes in them.

- After a week, yellow lochia may appear. The appearance of mucus in postpartum secretions and the almost complete disappearance of red blood cells gradually “discolor” the lochia.

- After ten days, the lochia lose their yellowish tint and become light.

- Against the background of complete recovery of the mucosa, after three weeks, the lochia becomes normal, but their number may still be a little more.

The complete disappearance of lochia should occur no later than six weeks after childbirth or caesarean section, when the tone of the uterus and its internal structure restored to prenatal values.

Sometimes women mistakenly take early menstruation after childbirth for returning lochia. One and a half or two months after childbirth, non-breastfeeding may have the first postpartum menstruation, which means the completion of all involutionary processes and the restoration of the hormonal background. In nursing mothers due to high content prolactin menstruation comes later, often it appears after the cessation of the lactation period.

Regardless of the method of giving birth to a child, a young mother can help her body tired from hard “work” to recover and prevent the development of infectious complications. To do this, you just need to follow the easy rules:

- Proper hygienic regimen. It is necessary to contain the body and intimate area clean by showering regularly.

Pads should be changed after three hours, even when slightly soaked.

It is strictly forbidden to use hygienic tampons. Blood is considered the universal medium for reproduction. pathogenic microorganisms. In conditions of reduced local immunity conditionally pathogenic microflora of the vagina is able to quickly begin to vegetate and provoke infectious inflammation. Neighborhood of an infected tampon next to an "open" one cervical canal can lead to the fact that the infection freely rises into the uterus.

- You should not stop breastfeeding without a good reason. In lactating women, the involution of the uterus is completed faster, since the oxytocin produced during feeding enhances uterine contractions. Frequent breastfeeding promotes quick recovery uterus and prevents infection and bleeding.

- If stitches remain in the area of ​​​​the external genitalia after childbirth, they must be regularly treated with antiseptic solutions according to the doctor's recommendations. You can also use herbal decoctions (sitz baths or irrigation) with anti-inflammatory and wound healing effects.

- Excessive physical activity, coupled with the load on pelvic muscles or the anterior abdominal wall (abs) should be excluded until the muscles regain their former strength.

- Sexual abstinence should last at least three weeks after childbirth or until the complete healing of postpartum injuries in the perineal area and / or on the cervix. Generally, recommendations for renewal intimacy individually given by the doctor.

The recovery of the female body after childbirth mainly consists in the gradual reduction of the uterus, the mass of which in the first week is 0.5 kg, in the third - 0.25 kg and 0.05 kg in the eighth. This process is accompanied by postpartum contractions that occur when the uterus contracts, and the release of lochia - a wound secret. By their number, color and consistency, one can suspect the presence of any diseases.

Physiology

Through uterine contractions, the body tries to get rid of everything superfluous that has accumulated in the process of bearing the fetus and childbirth - the remains of the placenta, the old thickened layer of the endometrium, excess fluid, plasma, mucus from the cervical canal and other postpartum secretions.

This process takes place in several stages:

Period after childbirth	Lochia color	Abundance lochia	Character and cause
0–3 days	red	plentiful	bleeding due to ruptured blood vessels and an open wound in the uterus
3–4 days	bloody-serous		clots are released (dead epithelium and placental remnants); mucus is secreted (residual products of intrauterine life)
5–7 days	brown	medium	the number of clots and mucus decreases
7–10 days	light brown	meager	lochia have a thick texture without inclusions
10–15 days		intensify	discharge after childbirth is increased due to the formation of a scab when the uterus heals
15–50 days	transparent with a yellow tint	smears	discharge is almost not observed due to the restoration of the endometrium

Many mothers are interested in how much discharge goes after childbirth. Usually they last one and a half to two months, but deviations are possible, so the total period is 4–9 weeks. By this time, the function of endometrial formation is fully restored, after a few weeks the egg can mature, and after a month, menstruation begins.

For the first week, lochia smells of sweetness, dampness and even mustiness - this is the norm. A sharp, sour and putrid smell should alert.

In lactating women, lochia usually ends after 4-5 weeks, since during lactation, the body releases oxytocin, a hormone that helps reduce the muscular layer of the uterus. As a result, discharge after childbirth comes out faster, but along with this, there are pain of varying intensity, resembling contractions. With artificial childbirth, the uterus contracts less often and, accordingly, heals more slowly, so lochia may be present up to the ninth week.

If bleeding occurs later than the fifth postpartum day, you should consult a doctor!

Color and abundance of lochia: norm or pathology?

Although the body of each woman is individual, deviations in color scheme specified in the table should not be. And at the first appearance of lochia of a specific color, you should consult a doctor.

You need to bring a pad with a sample of discharge to the appointment, do not hesitate to do so, because an unusual shade can be a sign of serious illness.

Color	Other symptoms	Pathology
bright yellow	admixture of greenery; putrid smell	Endometritis - obvious, with the appearance of yellow postpartum discharge on the 5–6th day, and hidden if they occur on the 10–20th day
		endometritis is treated with surgical cleansing of the lining of the uterus
green	slime; droplets of pus	advanced endometritis
white	itching and pain in the perineum; sour smell; curdled consistency	infections genitourinary system(colpitis, thrush)
black	–	in the absence of others pathological symptoms is the norm due to hormonal failure and change chemical composition blood

A slight deviation of lochia in color towards a pale yellow and gray hue is considered the norm.

With the normal course of the process, abundant discharge after childbirth is observed only in the first days. meager discharge indicate an inflection of the uterus or blockage of the uterine ducts and tubes, and therefore require immediate medical advice. In addition to blockage by clots of dead tissue, there is a possibility of a blood clot, which requires surgical intervention. If the abundant postpartum discharge lasts more than three weeks, it means that internal failures interfere with the normal healing of the uterus. intimate contact and physical exercise prohibited until the full recovery of the woman.

There are cases when weak spotting appears after childbirth on the 21st-30th day. This "small menstruation" is a sign of the restoration of the female reproductive system. If there are no pathological symptoms, then you should not worry.

Hygiene

Three days after childbirth, the uterus still remains sterile, and after that it becomes an open wound, into which an infection can easily be introduced.

Hygiene is the main method of prevention.

1. The first days after childbirth, you need to wear special absorbent diapers.
2. Gaskets should be bought without fragrances and with a high degree of absorption.
3. The use of tampons for discharge after childbirth is prohibited.
4. It is recommended to change pads every 3-6 hours or more often if lochia is abundant (according to the degree of wetting).
5. After each visit to the toilet, you need to wash yourself using a baby or laundry soap. The jet of water must be directed only from front to back.
6. Treat the seams on the surface (if prescribed by a doctor) should be antiseptic solutions(potassium permanganate, furatsilin).
7. Until the moment of complete healing of the uterus, it is forbidden to take a bath, visit the sauna and pool. Only showering is allowed.

Thinking about how long the discharge after childbirth lasts, it is worth noting that the process of cleaning the body can be accelerated by following these recommendations:

• you need to give the baby a breast on demand (in the absence of milk, the doctor can prescribe oxytocin to the woman);
• must be emptied regularly bladder(every 3 hours) and intestines (at least once a day);
• sleep and lie better on the stomach;
• once a day, a cold heating pad can be applied to the lower abdomen.

All these actions stimulate the contraction of the uterus, causing the rapid discharge of secretions after childbirth and contributing to the restoration of the genitourinary system.

After the long-awaited baby is born, processes are launched in the woman's body aimed at restoring organs and systems. Undoubtedly, the primary changes occur in the organ, which for nine months was a warm and cozy home for the crumbs - in the uterus. Who would have thought that a uterus, the size of a matchbox, could grow like that? ITS weight in a non-pregnant woman is only 50 grams, and by the end of gestation it is already equal to 900-1000 grams.

The postpartum period, during which the uterus contracts, is accompanied by bloody discharge from the genital tract - lochia. How long does the discharge after childbirth normally last, and what signs indicate the pathological course of the postpartum period? About this in our article.

Discharge after childbirth. How long do they last and why do they occur?

Perhaps, such a huge number of vessels, as in the uterus during gestation, is not in any other organ. And this is understandable, because another little man lives and develops inside a woman, who needs an uninterrupted supply of oxygen and nutrients. For this purpose, a baby place (placenta) is attached to the wall of the uterus, which performs a transport function. The third circle of blood circulation, formed during pregnancy, includes the uterus, placenta and fetus, and is called "utero-fetal-placental".

How long the discharge lasts after childbirth - it all depends on the contractility of the uterus. After the birth of a child, the uterus begins to actively “shrink”, pushing out everything that is in its cavity. As a result of this, the placenta attached to the wall of the uterus is separated, and the gaping blood vessels subside. As the size of the uterus decreases, the amount of discharge from the uterus after childbirth also decreases.

How long does lochia last after childbirth?

In the normal course of pregnancy and childbirth, the duration of the postpartum period is from 1.5 to 2 months, therefore, during this time, the release of lochia, consisting of blood, endometrial cells and mucus, continues. The better the uterus contracts, the shorter the period of discharge after childbirth.

During the first three weeks postpartum discharge is as follows:

• Lochia days 1 to 5 bright red, quite plentiful;
• From 6 to 10 days, spotting becomes dark brown, less abundant;
• From 11 to 15 days, lochia have a yellowish tint due to the high content of ichor (lymph);
• From the 16th to the 20th day, the discharge from the genital tract is almost transparent, scarce.

IMPORTANT! Abundant or prolonged postpartum discharge may indicate the development of a pathological process in the uterine cavity, which is a good reason to see a doctor.

How long does discharge last after childbirth by caesarean section?

After a caesarean section, an incision remains on the uterus, which means that the contractility of the organ is somewhat reduced. Despite this, the duration of the postpartum period should not exceed 8 weeks, otherwise they are talking about postoperative complications.

How long does discharge last after childbirth? If the lochia stopped prematurely.

Sometimes it happens that lochia after childbirth is allocated less than 6 weeks. Unfortunately, a short postpartum period often indicates not a good uterine contractility, but rather pathological process in her cavity.

The reason for the premature cessation of discharge is a spasm in the cervical region; the outflow of lochia from the uterine cavity is disturbed.

How long does lochia last after childbirth? When the postpartum period is delayed.

Reasons why lochia discharge lasts more than 8 weeks:

• insufficient uterine contractility (uterine hypotension, placental lobule defect);
• blood clots in the uterine cavity, as a result of which the uterus is not able to fully contract;
• inflammation inner shell uterus (endometritis): develops against the background of infection.

IMPORTANT! In the normal course of the postpartum period, the amount of discharge gradually decreases, while the lochia should not have a sharp or purulent odor. The woman's body temperature does not rise.

How long does discharge last after childbirth? Anxiety symptoms.

• Increased pain in the lower abdomen;
• Rise in body temperature, chills, weakness, headache;
• A sharp change in the volume of bloody discharge (decrease or increase);
• The smell is bad, sharp, unpleasant, the discharge has acquired a yellow tint (pus).

The duration of discharge after childbirth. How to prevent inflammation?

With normal uncomplicated childbirth and the absence of severe concomitant pathology, each young mother is able to prevent the development of inflammation in the uterine cavity. To do this, it is enough to follow unfalse recommendations.

1. Compliance with intimate hygiene.

Pads in the postpartum period should be changed at least once every 3-4 hours. You will have to forget about hygiene products such as tampons during the postpartum period. It is necessary to take a shower at least once a day, to wash yourself in the morning and in the evening, and also after each visit to the toilet.

2. Frequency of urination.

A full bladder compresses the uterus, preventing it from fully contracting. In addition, with prolonged abstinence from urination, stagnation of urine occurs, which contributes to the rapid reproduction pathogenic microflora in the ureters and urethra.