When a woman is discharged from the hospital, she is usually asked to come to the clinic for a follow-up check 42 days after delivery.
The period from the delivery of the placenta to the return of all organs of the mother’s body, except for the breast, to their normal non-pregnant state is called the puerperium, which is usually 6 weeks, or 42 days. The condition of the puerperium is related to the physical and mental health of the mother, especially the recovery of the reproductive system.
What is postpartum dew?
After childbirth, as the uterine membranes shed, blood, necrotic membranes and other tissues are discharged through the vagina, resulting in the so-called postpartum dew.
The amount of nightmare discharged is not the same for each person, but the average total amount is 250-500 mL. It can have a bloody smell, but no odor, and its color and contents change over time.
1. Bloody nightmare
It is named because it contains a lot of blood. It is bright red in color, with a lot of volume and sometimes small blood clots. Microscopically, there are many red blood cells, necrotic meconium and a small amount of fetal membranes. As the bleeding gradually decreases, bloody nightmare usually appears only in the first 3 days after delivery, and then gradually changes to plasma nightmare.
2. Plasma nightmare
It is named after the amount of plasma and is light red in color. Microscopically, more necrotic meconium, uterine exudate, cervical mucus, a small amount of red and white blood cells, and bacteria are seen. Plasma malodex usually lasts from 4 to 14 days, after which the plasma gradually decreases and becomes white malodex.
3.White nightmare
It is called white because it contains a large number of white cells and has a white color and is viscous. Microscopically, a large number of white blood cells, necrotic meconium, epidermal cells and bacteria can be seen. The white nightmare lasts about 3 weeks and clears up. When breastfeeding, the child sucks on the breast, which promotes the production of prolactin and contraction of uterine hormone, causing reflex contraction of the uterus, which facilitates the discharge of malodex from the uterine cavity and reduces postpartum bleeding.
The incomplete dew not only prolongs the postpartum recovery time, but also is often associated with poor uterine regeneration, late postpartum bleeding, puerperal infection and other diseases, and has become a common disease in obstetrics and gynecology.
When does the postpartum dew stop?
Normal nightmare usually lasts for 4-6 weeks. If more nightmare is still coming out after 6 weeks, it is called prolongedlochia.
What is the reason for prolonged lochia?
After excluding organic lesions, the following factors should be considered
1. Retained placenta and membranes
After delivery of the placenta, the placenta and fetal membranes should be carefully checked for completeness, especially the parietal placenta, which is easy to ignore and adheres to the residual tissue in the uterine cavity. The clinical manifestations are long duration of bloody malignant fluid, repeated bleeding or sudden haemorrhage.
2. Meconium residue
The meconium is mostly shed within one week after delivery and is discharged with the malodex. If the meconium is not fully shed, it will affect the uterus recovery and cause endometritis. The manifestation is that the malodex is not clean, the bleeding volume is sometimes more and sometimes less, and it is accompanied by abdominal pain.
3.Puerperal infection
Poor healing of perineal incision and vaginal laceration infection after delivery. Unclean sanitary napkins and premature sexual intercourse after delivery can cause endometritis. At this time, there is a foul smell of malodorous dew, obvious uterine pressure and pain, accompanied by fever, chills, headache, significantly elevated white blood cells and other symptoms of infection.
4, poor uterine regeneration
Poor postpartum rest, weakness, prolonged labor or cesarean section can cause poor contraction of the uterus and incomplete dew.
It is recommended to go to the hospital in time to identify the cause and treat it.
Prevention and treatment with two hands
1.Prevention and intervention
(1) Check carefully if the placenta and membranes are complete after delivery, and clear the uterus as soon as possible if there is placental residue.
(2) For women with pregnancy complications or complications, pay special attention to postpartum hemorrhage. For those with premature rupture of membranes and long labor, use antibiotics to prevent infection after delivery.
(3) Early postpartum contact between mother and baby, and adhere to breastfeeding, not only can promote the growth and development of the newborn and maternal lactation, but also can promote maternal uterine regeneration.
(4) Pay attention to the color, amount and odor of the malodor and the contraction of the uterus after delivery. If you notice a foul odor and poor contraction of the uterus, you need to consult a doctor promptly.
(5) Pay attention to the amount of nightmare, if it is more than the amount of menstruation, and if it is bright red in color, seek medical treatment promptly.
(6) Wash your vulva daily to keep it clean. Change the sanitary napkin regularly to keep it fresh and prohibit intercourse for 6 weeks.
2. Examination and treatment
This includes gynecological examination and ultrasound examination. Gynecological examination can clarify the source of bleeding and exclude vulvar, vaginal and cervical bleeding. Ultrasound examination can identify whether there is any residual tissue in the uterine cavity and the status of uterine regeneration.
In recent years, cesarean delivery has been widely used clinically as an effective means of clinically resolving obstructed labor and certain obstetric complications, which has increased the incidence of incomplete postpartum malignant dew.
Because the placenta and membranes are delivered by cesarean section under visualization, there is no residual problem. The causes are mostly poor contraction of the uterus, poor healing of the incision and endometritis.
The management of these patients is: 10 U of contractin, intramuscularly, once in the morning and once in the evening, for 3 days. In case of infection, anti-inflammatory treatment with antibiotics is indicated.
The main causes of incomplete postpartum effusion in women who delivered vaginally are poor uterine regeneration, retained fetal membranes and late postpartum hemorrhage due to infection.
Treatment: Most of them are treated with uterine contractions, and sometimes they can be combined with certain herbal medicines that are effective.