Incomplete delivery of the placenta is a condition in which at the final stage of childbirth, the entire placenta or some part of it remains in the uterus. The final stage is called the third stage of labor, when the birth of the placenta occurs. Incomplete delivery of the placenta requires medical care, and it will be provided to you directly at the maternity hospital.
Normal third stage of labor medical intervention lasts 10-20 minutes, during which you have contractions and attempts to help the placenta pass. Sometimes this process can take up to an hour, and if necessary, it can be accelerated using the same stimulants that are used in childbirth. In this case, we are talking about stimulation childbirth, and then the discharge of the placenta occurs in 5-10 minutes. The use of stimulation at the birth of the placenta prevents the risk of high blood loss in the mother.
If the placenta has not completely passed, you will receive medical attention. Depending on the views of the doctor who takes delivery, and on the course of the birth itself, stimulation will be carried out:
- within half an hour after birth
- immediately after incomplete delivery of the placenta
Why and how does part of the placenta stay in the uterus?
There are three main reasons:
- low uterine tone- it means that the uterus stops contracting after childbirth or contracts so weakly that the placenta cannot separate from the uterine wall
- retention (capture) of the placenta- the placenta is completely separated from the wall of the uterus, but does not come out, because it is delayed by the cervix
- placental accreta- part of the placenta is too strongly attached to the wall of the uterus and cannot detach on its own.
Retention of the placenta can occur when assistive techniques are used in the final stage of labor, when the placenta is pulled by the umbilical cord. The midwife gives an injection, waits for the placenta to detach, and puts one hand on your stomach, as if holding the uterus, and with the other hand pulls on the umbilical cord.
If the placenta has separated, then it easily slips out of the vagina. But if it is not completely separated, if the umbilical cord is too weak, or if the midwife pulls too hard and abruptly, then the umbilical cord can break, leaving the placenta in the uterus. In these cases, it is recommended to push in contractions. However, sometimes the cervix begins to contract rapidly, thereby preventing the placenta from coming out.
Sometimes it happens that the placenta has an additional share (it is usually connected by a separate vessel to the main placenta), which does not separate and / or lingers in the uterine cavity. That is why the placenta is carefully examined after childbirth: if a doctor or midwife notices a piece of a vessel, this will raise suspicions that some share has remained in the uterus.
Sometimes part of the placenta is attached to a fibroma or scar from a previous one.
Sometimes a full bladder interferes with the placenta. In this case, the midwife will put a catheter in your bladder to empty it.
What are the consequences of incomplete delivery of the placenta?
Normally, after the birth of the placenta, the uterus begins to contract to close the bleeding blood vessels. But if the share of the placenta remains inside, a complete contraction does not occur and the vessels continue to bleed.
If, despite the use of assistive technologies at the final stage of labor, the placental discharge lasts longer than half an hour, the risk of acute uterine bleeding increases. Large blood loss in the first day after childbirth is also sometimes called postpartum hemorrhage.
If fragments of the placenta are not removed from the uterus in time, severe blood loss and infection can occur. It occurs in 1% of births.
How to treat?
If the final stage of labor is delayed, it is recommended to apply the baby to the breast or manually stimulate the nipples, as this causes uterine contractions and rapid withdrawal placenta. If possible, take an upright position - the force of gravity can also help.
If you opt for medical intervention, you will be given an injection of oxytocin and the midwife will pull the placenta out by the umbilical cord. When this fails, the placenta must be removed manually. In this case, do spinal or anesthesia, or general anesthesia.
Before removal of the placenta or part of it, the midwife will place a catheter for emptying Bladder and will do intravenous injection antibiotics to prevent infections. After the placenta has been manually removed from the uterine cavity, you will be given intravenous medication to shrink the placenta.
If you continue profuse bleeding within a few days or weeks after delivery, you will be sent for an ultrasound to check if there are fragments of the placenta in the uterus. If suspicions are confirmed, you will be sent to the hospital for surgical removal remnants of the placenta from the uterine cavity. It is performed under anesthesia and is accompanied by the introduction of antibiotics.
In my first birth, I had an incomplete placenta. Is there any way to avoid this the second time around?
Unfortunately, if you have already had an incomplete placenta, you run the risk of getting it again. If the previous case was caused by placental ingrowth into a scar from caesarean section or an increment, then you have a great chance to repeat the previous scenario, and it is difficult to influence the situation.
Incomplete discharge also occurs more often with, since the mature placenta is more easily separated from the uterine wall. So if you have one more premature birth, the risk of a similar outcome is high.
However, if the previous situation was related to stimulation and the cervix closed too early or the umbilical cord broke, then you should discuss with the midwife the possibility of not using assistive techniques in the final stage of labor this time. Maybe it's better to spend it naturally, because in this case the cervix will not close too quickly, preventing the placenta from coming out.
After the birth is over, the baby will be born and the afterbirth will come out, the restoration of the body begins. The first process is the reduction of the uterus to its previous size. This body has amazing properties, since when carrying a baby it increases significantly. The uterus after childbirth has a weight within 1 kg, and by the end recovery period- only 50 g.
However, the recovery process can be complicated by a number of pathologies that occur only after childbirth and before that it is impossible to foresee them, respectively, to prevent them too. For example, the neck may be deformed.
Only a doctor will be able to notice the violation during the examination. Normally, the outlines of the external os should be round, but in pathology they take the form of a gap. In this case, the neck itself will not be cone-shaped, as expected, but cylindrical. This and other disorders can affect a woman's fertility and make future pregnancies more difficult.
How to shorten the uterus after childbirth?
In normal postpartum period the body is completely cleared of the remnants of the placenta and blood clots in 3 days. The activity of this process is evidenced by the discharge - bloody in the first days and serous-sanious in the following.
The epithelium will fully recover after 3 weeks. The process of contractions is accompanied by a slight cramping soreness. After repeated births, this phenomenon may be more pronounced, and in some cases the woman is prescribed painkillers.
The absence of contractions (atony) or their weak intensity (hypotension) are pathologies and dangerous to health.
The activity of contractions depends on several factors: the number of fetuses, the location of the placenta, complications during the birth process, the weight of the child, the state of health of the woman in labor.
Atony occurs in case of bending, injuries of the birth canal, underdevelopment of the organ, inflammatory processes, the presence of fibroids, polyhydramnios, and bleeding disorders.
To reduce the uterus, the doctor may prescribe special drugs that will stimulate this process - oxytocin or prostaglandins.
The impulse can be breast-feeding, so that it is worth feeding the baby at his first request. A woman should move more, even if a caesarean section was performed. It is better to sleep and rest on your stomach. It is worth noting that the emptying of the bladder can affect the rate of contractions, therefore, if there is no edema, it is necessary to drink more fluids and go to the toilet more often.
The danger of atony lies in the fact that the body cannot get rid of the remnants of the placenta and blood clots. If they remain, inflammation will occur. So necessary procedure if the above methods did not help, there will be scraping, or cleaning. If this procedure is not carried out, then a hysterectomy will be required in the future.
When is cleaning necessary?
Cleaning of the uterus is carried out after childbirth, if parts of the placenta remain in it or blood clots have accumulated. You can detect the remains on a planned ultrasound examination, which is carried out after childbirth.
Why doesn't the body cleanse itself? The reason is the weak generic activity when the doctor had to manually separate the placenta, or if the latter is very tightly attached.
Cleaning is carried out both medically and operational method. She is mandatory procedure with the above pathologies. If such an event is not carried out, then complications will arise in the form of an inflammatory process and endometritis.
If clots are found in the uterus on ultrasound after childbirth, the doctor prescribes curettage, which is performed under general anesthesia. The operation time is no more than 20 minutes.
The procedure, like any other intervention, can be accompanied by complications. Most often, there is a hematometra - a delay in the cavity of the blood organ caused by a spasm of the neck. If the discharge from the vagina after curettage quickly stopped, then there is this complication. To relax the neck and prevent the hematometer, No-shpu is prescribed.
Women with bleeding disorders may experience uterine bleeding, but this is quite rare.
If bacteria get into the cavity during cleaning, endometritis occurs - inflammation of the mucous membrane.
What is fraught with uterine bending?
The bend of the uterus, or displacement, after childbirth occurs due to weakness of the muscles of the pelvis and a decrease in the tone of the ligaments. These factors, in combination with complicated childbirth, provoke some deviation of the organ back. The movement is accompanied by a bend.
Such a violation provokes a reduced activity of the genital organs, characterized by pain syndrome and functional deviations in this area. The bend is eliminated using the complex special exercises which a woman can easily perform at home.
Myoma
This pathology, unfortunately, is one of the most common. It is characterized by the fact that benign tumors form in the muscular membrane of the organ.
If treatment is not started in a timely manner, then there is a high risk of developing early and late complications after the birth of a child, or rather:
- Excessive postpartum bleeding;
- Placenta accreta;
- Low tone of the uterus;
- Excessively tight attachment of the placenta and its partial separation;
- The uterus is not able to restore its previous size;
- Infection of the organ cavity.
polyps
hallmark this disease is difficult to diagnose because initial stage falls on postpartum hemorrhage characteristic of this period. main reason polyps is considered an abortion or a history of curettage. It is possible to detect a placental polyp only with the help of ultrasound.
A woman needs hospitalization and a curettage procedure after delivery, when the remains of the placenta and blood clots are removed. V rehabilitation period she should take antianemic and antibacterial agents.
Removal operation
Hysterectomy - surgery to remove the uterus is performed according to the indications, which include:
- Enometriosis, inability to stop uterine bleeding;
- Prolapse of the uterus as a result of rupture of the pelvic floor;
- The reproductive organ after displacement disrupts the functions of the gallbladder.
Inflammation
Reasons for development pathological process quite a lot: caesarean section, prolonged labor, placenta previa, lack of or non-compliance with hygiene / sanitary standards, etc. The symptoms of the disease include fever, rapid pulse, soreness and an increase in the abdomen, fever, purulent discharge from the vagina.
If a woman is concerned about the above phenomena, do not delay a visit to the doctor. Postpartum complications can occur even when the mother and child have already been discharged home.
In order to protect yourself from the development of pathology and prevent violations of reproductive functions, you need to contact a specialist who can make the correct diagnosis and prescribe adequate treatment, or reassure the woman if no diseases are found.
The birth of a child is a joyful and exciting moment. But with the advent of the baby, one should not forget about one's own well-being. In the early days, a woman becomes more vulnerable. The body has experienced severe stress, and it needs strength to recover. Special attention doctors give the state of the genital organ. The uterus for the first week decreases in weight from one kilogram to three hundred grams. By the end of the recovery period (in 1-2 months), it will have a mass of only 70 grams. But it doesn't always happen that way. There are cases when, after childbirth, they remained in the uterus. What to do in this case? You will learn about the methods of treatment in today's article.
Diagnosis and symptoms of clots in the uterus
In all newly-made mothers, before discharge, they are sent for ultrasound and gynecological examination. These manipulations are necessary to assess the condition of the woman. If a clot remains in the uterus after childbirth, then an increase in the organ is noted. woman complaining about pain in the lower abdomen, the temperature may rise and malaise may occur. All these symptoms indicate that the newly minted mother needs medical help. What to do if there are clots in the uterus after childbirth?
Manual separation of residues and massage
As you already know, every woman who has given birth is given an ultrasound. During the examination, the doctor can determine the location of the lumps of mucus. If there is a clot in the uterus, massage is performed after childbirth. Its purpose is to increase the contractility of the genital organ to expel mucus. Massage is carried out every 2-3 hours. The doctor presses on the lower abdomen, pushing the clots to the mouth of the uterus. The procedure is recognized as quite painful, but you can not do without it.
Gynecologists also use manual separation of clots. The mouth of the uterus in the first three days after birth is open by 8-12 centimeters. This distance allows you to easily manipulate without using dilators.
Medical treatment: drugs
If a clot is found in the uterus after childbirth, then the woman must be prescribed drugs that enhance the contraction of the muscular organ. Most often it is "Oxytocin", "Hyfototsin", "Dinoprost", "Ergotal" and others. Some practice the prophylactic use of the described means. But the attitude of physicians to this approach is ambiguous.
In addition to drugs that reduce the uterus, a woman is prescribed antibacterial drugs. At the same time, the question of the possibility of further breastfeeding is being resolved. Opinions of gynecologists differ here. Some experts believe that it is necessary to take antibiotics in order to prevent inflammatory process. Other doctors say that breastfeeding should be continued as it encourages the natural contraction of the uterus.
If a pathology is detected, it is forbidden to take antispasmodics that relax the muscles.
Cleaning of clots in the uterus after childbirth: surgical treatment
If the remains of the fetal membranes or placenta are determined in the cavity of the genital organ, then the woman is prescribed gynecological curettage. It is made under anesthesia. Depending on the complexity of the operation, it can be local or general.
During the procedure, the doctor introduces instruments into the uterine cavity, which cleans the mucous membrane. This operation obliges a woman to linger in the walls medical institution for another 1-2 days.
Folk remedies for reducing the reproductive organ
Is it permissible to use grandmother's recipes if there is a clot in the uterus? After childbirth, taking various herbs can be quite dangerous, since not all remedies are allowed during lactation. Many substances can cause allergic reaction The child has. If you are not breastfeeding, then you can try to get rid of the pathology with the help of herbs. But remember that gynecologists do not advise self-medication. And prolonged presence of clots in the uterus can lead to infection or sepsis.
- It is known that this plant helps to increase the contractility of the uterus. You need to brew nettles in the amount of 4 tablespoons per half liter of boiling water. Take an infusion of 100 ml three times a day.
- Shepherd's bag. This herb also has the ability to activate the work of the muscular organ. Boil two glasses of water and dip 4 tablespoons of herbs into it. Leave to cool, strain. You need to drink this amount during the day.
- Blood red geranium. Take 2 teaspoons of the herb and pour in 400 milliliters of chilled water. Leave the preparation overnight, and strain in the morning. Drink throughout the day.
There is an opinion that large doses of vitamin C cause contractions of the reproductive organ. Therefore, if there is a clot in the uterus after childbirth, women try to consume foods containing it. These are lemon, cabbage, parsley, oranges and so on.
What can a woman do on her own?
If clots are found in the uterus after childbirth, what should I do? By executing simple tips a woman can independently provoke the release of mucus. Ask your doctors about these methods. Here are some recommendations.
- Breastfeed your baby more often. Stimulation of the nipples and sucking movements of the baby contribute to the production of natural oxytocin and uterine contraction. In the first days after childbirth, this is especially noticeable. As soon as the baby begins to suckle the breast, the genital muscular organ contracts.
- Lie on your stomach. abdominal wall and the muscles after the birth of the baby do not immediately return to their original state. Therefore, an inflection of the uterus may occur, which is why clots form. To prevent this from happening, lie on your stomach more often.
- Lead an active lifestyle. If you have no contraindications, then you need to move more. Walk, walk, carry your baby in your arms. The higher will be physical activity the faster the uterus will contract.
- Use improvised means. After childbirth, in the absence of contraindications, tighten the stomach. To do this, you can purchase a special bandage or use a sheet.
- Do Kegel exercises. Rhythmically squeeze and unclench the muscles of the vagina and anus. It might not work well at first. But such gymnastics not only contributes to the release of clots, but also accelerates the recovery process.
- Watch your stool and empty your bladder more often. After childbirth, a woman practically does not feel the urge to urinate. But you need to urinate. Contractions of the bladder, intestines and increase uterine tone.
Special situations: caesarean section and artificial birth
What to do if a clot is found after a caesarean section? The uterine cavities after childbirth in this way are reduced a little differently. The fact is that the muscle layer is injured. Therefore, in the place where the incision is made, the tone will be reduced. As a result, clots appear. But cleaning after a C-section can be quite dangerous. What to do in this situation - only the doctor decides, based on the individual characteristics of the patient and the result of the operation.
Quite often clots are formed after artificial childbirth on early dates. In these cases, lactation is not getting better, and the body is hormonal disbalance. Therefore, the uterus contracts badly. With artificial delivery, a woman must be prescribed drugs based on oxytocin for prevention. When clots are detected, one of the correction methods described above is selected.
Summarize
If a woman develops clots in the uterus after childbirth, treatment should only be carried out by a gynecologist. Never try to get rid of lumps of mucus on your own. If you are breastfeeding, then it is strictly forbidden to take any medication without prior medical consultation. Wishing you a speedy recovery!
Very often, after childbirth, a woman has clots in the uterus. During pregnancy and the birth of the baby, this organ undergoes major changes. After the baby is born, he does represent one big wound.
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The uterus pushes the baby out with muscle contractions, and then the umbilical cord, placenta, and fetal membranes come out of it. But sometimes after childbirth, blood clots, fragments of the placenta and mucus remain in the uterus. They continue to come out for about 1.5 months. Pro .
It is worse if, after childbirth, the formed blood clots remain in the organ. This situation the gynecologist should decide, since it is quite dangerous. But, if you ask for help in time, there will be no problems.
Reasons for the appearance of neoplasms
Sometimes, after giving birth, some blood clots remain in a woman's uterus. It's quite common occurrence during the first days of menstruation. Neoplasms come out in the first few days and are similar to ordinary ones. copious discharge menses. Remnants of the placenta and other “products” that were formed during pregnancy come out of the organ. But sometimes this doesn't happen.
There are a number of causes of this disease associated with the work of the reproductive organ.
The following factors are to blame:
- sluggish contraction of the organ;
- a large number of placental remains;
- spasm of the cervical canal.
This can happen at any age and does not depend on various problems during pregnancy. Usually large blood clots continue to come out for 5-7 days after delivery. After some time, the discharge becomes smearing.
When, after 2-3 weeks, blood clots continue to come out, most likely a placental polyp has formed. This happened because the placenta was not completely delivered. You need to be wary if the discharge was at first plentiful, and then almost completely disappeared.
At the same time, ultrasound shows that the uterus remains enlarged. This often indicates that there are few clots left in the female uterus after childbirth. If the diagnosis is confirmed, urgent action will have to be taken. Blood neoplasms need to be given a way out, since ignoring the problem threatens with serious diseases.
Sometimes there are situations when, after 2-3 days of "rest", the ill-fated clots that remain in the body reappear. At the same time, you need to track possible symptoms inflammatory process:
- unpleasant odor from the vagina;
- pain;
- high temperature when measured not in the area of \u200b\u200bthe mammary glands, but on the elbow bend.
You should be very careful, because the inflammatory process (endometritis) can adversely affect reproductive function organism. If you ignore the problem, it can cause infertility.
What to do with the problem
After childbirth, all blood clots in the uterus come out of it on their own. If this does not happen, and the blood has stopped flowing, you need to urgently consult a doctor. Obstetrician-gynecologists know how to cope with this unpleasant phenomenon and will do everything necessary measures. Often the trouble manifests itself during the first few days when a woman with her baby is in the hospital. Preventing pathology is simple, as doctors take a blood test from patients and check it for hemoglobin. This allows you to notice the development of the problem in time.
If you find this in yourself, consult your doctor.
It also happens that the pathology manifests itself a few days after discharge. Do not put off a visit to the gynecologist, even if you have no time catastrophically. Take the time, otherwise you will have to spend a lot of effort and money on treatment later. Such formations can be an excellent environment for the development of infection.
If you ignore the treatment, the pathology will cause the following diseases.
- Inflammation of the mucous membrane (endometritis).
- Subinvolution of the uterus (the organ stops contracting).
- Inflammation due to infection in stagnant clots.
- Blockage of the uterus.
If after childbirth a woman does not have clots, the gynecologist directs her to ultrasonography to confirm the diagnosis. Once the problem is confirmed, a cleanup is usually performed. This is the only way to remove stagnant blood.
After this procedure, neoplasms are transformed into the state in which they should be. If after childbirth the patient has blood clots, she is often prescribed antibiotic therapy. That's the only way to deal with bacterial infection in the uterus.
In this case, the doctor focuses on the presence or absence of a lactation period. In any case, a woman is advised to feed the baby before taking the medicine. It won't hurt a baby to take bifidumbacteria to avoid side effects and support bowel movements that may be disrupted by medications taken by the mother.
You do not need to decide on your own what to do if you have clots in the uterus after giving birth. If the cause is in the placenta that has not left the uterus, vacuum aspiration will have to be performed. Experts recommend performing it under optical control. This will allow you to be sure that the neoplasm is gone, and the procedure will not have to be repeated. Do not worry about discomfort during medical manipulations. Vacuum aspiration takes place under general anesthesia, so it is completely painless for a woman.
If an ultrasound study confirms the diagnosis, and there are indeed many lochia in the uterus, but there is no placental polyp, special preparations will have to be used. Medicines will "force" the uterus to contract. Specialists often use Oxytocin. The drug is administered through a dropper or intramuscularly. The drug is usually used for three days. In this case, you need to be examined daily by a doctor who will control the size and soreness of the uterus.
Period after pregnancy
Approximately nine days after delivery, blood should flow, but deviations often occur.
Previously, most women did not menstruate until after the end of the lactation period, but now female body works a little differently. Shortly after giving birth, the woman has her period again, but sometimes with clots.
Often this can be due to poor contraction of the uterus. To do this, you need to take special medications to normalize the condition and not harm the remaining clots. After taking medication, blood may begin to come out into the in large numbers for some time. Usually, this phenomenon is observed for about one month.
To avoid this pathology, it is necessary to follow a number of preventive rules.
If the problem recurs again, you should again consult a doctor for advice. When copious monthly discharge with clots is observed after childbirth, the cause may be the remnants of the placenta that did not come out during the very first bleeding. Sometimes given state also requires scraping. This procedure will completely clean the uterine cavity and eliminate all clots.
Prevention of the development of the disease
In order not to decide what to do with clots after childbirth, it is best to carry out prevention. To avoid problems will help to comply with several conditions:
- visit the toilet regularly;
- do not lift weights;
- limit strong physical activity;
Attention!
The information published on the site is for informational purposes only and is intended for informational purposes only. Website visitors should not use them as medical advice! The editors of the site do not recommend self-medication. Determining the diagnosis and choosing a treatment method remains the exclusive prerogative of your doctor! Remember that only complete diagnostics and therapy under the supervision of a doctor will help to completely get rid of the disease!
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