How much blood goes after ks. Discharge after caesarean section: timing, color, amount. The nature and duration of normal lochia

How long is the discharge after a caesarean section? A qualified gynecologist will tell you about this. The birth of a baby is always a holiday in the family. But we must remember that childbirth is always stressful for the body. Whether they occur naturally or through surgery, the uterus needs time to recover. How long will the postpartum period last and how long will the bleeding last after a caesarean section? After the operation, a certain time must pass until all the sutures are completely healed.

How long does discharge last after caesarean? This time is individual for each woman, but generally takes 5-9 weeks if there are no complications.

Of particular concern are the discharge after a caesarean section, which in medicine is called lochia. They consist of epithelium, bloody mucous clots, plasma and dead cells. Some women perceive them as a kind of menstruation. But in fact, their quantity, composition, texture, smell and color can change during the postpartum period and are a kind of indicator of the state of the body of a young mother.

The essence of the operation

A caesarean section is an operation during which not only the abdominal cavity is damaged, but also the integrity of the uterus. The latter is a hollow muscular organ. If the muscles are damaged, then their contractility also decreases, which means that the process of restoring the uterus, that is, returning it to its original size, will take longer.

How long should the yellow discharge last after a caesarean? Discharge after operative delivery is a product of uterine contraction, during which a lot of unnecessary is pushed out.

What are lochia?

What are the lochia after Cesarean and how much should these secretions be? Let's consider them separately. After Cesarean, the wound surface is larger, and this increases the risk of an inflammatory process. That is why it is necessary to observe hygiene procedures more carefully. They need to be done more than once a day.

At first, the mucous mass predominates. The color of the discharge is more saturated, brighter than after natural childbirth. Lochia also differ in time - with Caesarean they last 1-2 weeks. The process of healing the uterus itself takes more time.

All this can scare a young mother, but this is the norm and there is no need to be afraid. But in order for a woman to understand this, she needs to know the deviations.

What is the boundary between normal and abnormal? Although discharge is a natural phenomenon, it must be understood that childbirth and surgery are very stressful for the body. It is important for every woman to learn to listen to the signals of the body. This allows you to learn about the deviations that occur in the body and quickly solve problems.

A question of duration

Allocations after caesarean section - how long should they last? The main indicator is the time. If after a caesarean section from 7 to 9 weeks lochia is released, then this is considered the norm. But when they last less or longer, then you need to consult a specialist if there are other symptoms.

It happens that a young mother, out of inexperience, rejoices when the discharge ends earlier, for example, after 4 weeks. In fact, this is something to worry about, as dead tissue remains in the body, which can lead to infection. However, too long discharge can also be considered a pathology, because this may be a sign that a woman develops endometritis or an infectious process in the body, in particular in the genitals.

Such a case is also dangerous when lochia suddenly stops and starts again. This indicates the presence of any pathology. A woman can easily understand when she should see a doctor. Delay in this matter may lead to surgery.

Another signal may be the nature of lochia. Immediately after a caesarean section, they appear as a blood clot. This is due to the fact that the uterus in the initial stage looks like a huge wound. But then the nature of the discharge should change: they are joined by mucus, dead epithelial cells.

This all indicates that the process is going well and there is no need for concern. But if weeks pass, and the nature of the discharge does not change in any way, then this is a signal that the damaged tissues cannot recover in any way.

How long can spotting take? If there is blood, mucous secretions and clots with a smell, this is normal. And after 6-7 weeks, the color of the blood becomes brown and becomes more like normal menstrual smears.

The danger is represented by those lochia after Caesarean section, which consist of purulent secretions. They have a pungent odor and are greenish-yellow in color. Often there is a temperature after a caesarean section.

These may be symptoms of infectious or inflammatory changes. If there is a discharge of this color, you should immediately consult a doctor.

Women should also be alerted by those lochia that are devoid of color - white. They may be accompanied by:

itching in the groin,
redness of the skin
curdled texture,
unpleasant smell.

Watery discharge

Water discharge after Caesarean section with these symptoms is a sure sign that characterizes vaginal dysbacteriosis (gardnerellosis).

If, after a caesarean section, the lochia has a black color without smell and pain, then this is normal. This is due to hormonal changes that occur in the body after surgery.

It is important to pay attention to the number of lochia. If at first they are in small quantities, this is a symptom of clogged ducts.

But even with an abundance of lochia, it is also necessary to consult a doctor, since too many of them are a sign that there are problems in the process of restoring the uterus.

Especially dangerous are lochias, with a strong smell and a bright scarlet color. In this case, doctors may prescribe a course of antibiotics or surgery.

Hygiene in the postpartum period

There are various bacteria in lochia, and it is very important to carefully perform hygiene procedures during this period:

1. It is necessary to change the gasket every 2-3 hours, it is better to choose soft ones.
2. You can not use tampons, because in this case, the lochia will remain in the uterus and the number of bacteria there will begin to increase rapidly.
3. After urination or defecation, it is necessary to wash with running warm water.
4. You can’t bathe in the bath, as this can easily bring an infection. This can be done only after 1-2 weeks, depending on the condition of the uterus.

Not a single woman likes this period and everyone wants it to end as soon as possible. But you need to know that without this it would be difficult to protect the body from complications and inflammatory processes.

It is vital for young mothers to follow this process during the recovery period, since the nature, color, composition and volume of lochia indicate the presence of a particular disease. And often, failure to follow simple rules of hygiene or inattention can lead to disastrous consequences and even to surgical intervention.

This is the period when a mother needs her newborn baby the most. Therefore, take care of yourself and follow the signals that your body gives.

Pregnancy and childbirth is a rather serious stress, after which the body needs a long recovery. In the normal course of childbirth, the rehabilitation process is accompanied by moderate bloody discharge from the genital tract, and takes no more than 1-1.5 months, in case of complications during childbirth, the period may be somewhat delayed. Special attention deserves the nature and duration of discharge during delivery by caesarean section.

Lochia is bloody discharge from the genital tract that occurs in the postpartum period. Regardless of the method of delivery, the duration of lochia should not deviate from the norm. How long does discharge last after caesarean? What postoperative complications can change the duration and nature of lochia?

How long does the discharge go after cesarean, and what does it depend on?

The duration of lochia after operative delivery is one of the most important indicators in the postoperative period. A caesarean section is an operation in which not only the abdominal cavity is damaged, but the integrity of the uterus, which, in fact, is a hollow muscular organ, is also violated. It is known that when muscles are damaged, their contractility decreases, which means that the process of uterine involution - a physiologically determined reduction of the organ to its original size, in this case lasts longer. Allocations after cesarean section are due to the contraction of the uterus, which, as it were, pushes everything unnecessary out of the cavity. The lower the contractility of the organ, the longer the discharge after cesarean section will go.

IMPORTANT! If during the operation something went “wrong” (increment of the membranes, uterine bleeding, damage to adjacent organs), the duration of the lochia can also change, and not always in a big way. Such women in labor are usually under close supervision, since the risk of developing uterine hypotension and other complications in the postoperative period increases several times.

How long after a cesarean is the discharge normal?

The duration of lochia after caesarean section in the absence of complications is less than 5-6 weeks, as in natural childbirth. On the first day after the intervention, the woman in labor is in the intensive care unit, where hourly temperature, blood pressure, diuresis are monitored, and the amount and nature of bloody discharge from the genital tract is visually assessed. With a successful course on the second day, the woman is transferred to the postpartum department, where she remains until the moment of discharge.

IMPORTANT! Unlike normal childbirth, after a caesarean section, the uterus needs additional stimulation to contract. For this purpose, special injectable drugs are prescribed - uterotonics (methylergometrine, oxytocin).

How long does discharge last after caesarean?

First week after surgery.

Copious discharge with blood clots, having a rotten smell. The volume of lochia during this period averages 500 ml, so the lining has to be changed at least every 2 hours. Feeding, physical activity, palpation of the abdomen contribute to an increase in the contractility of the uterus and increased secretions.

2 weeks after caesarean section.

Lochia moderate, muco-bloody, acquire a red-brown hue. Every day the number of discharges decreases.

4 weeks after delivery.

At 4-5 weeks after cesarean, the discharge is dark brown, in a meager amount.
The process of complete recovery of the uterus is completed 6-8 weeks after surgery. By this time, the endometrium of the uterus is completely renewed, as a result of which the discharge becomes mucous, as before pregnancy.

What to do if the discharge after cesarean is less or more than usual?

The duration of lochia after cesarean directly depends on the contractility of the uterus, so any deviations from the norm should alert the woman.

If the discharge after cesarean went on and stopped abruptly, consult a doctor immediately.

This situation most often occurs when, with insufficient contraction of the uterus, its cavity is filled with blood clots, due to the presence of which the uterus is not able to fully contract. Stagnation of blood in the uterine cavity contributes to the reproduction of pathogenic microorganisms, as a result of which endometritis may occur - a rather severe complication of childbirth.

If the discharge after cesarean takes longer or becomes more abundant, immediately call an ambulance.

After operative delivery, the uterus contracts much worse, which increases the risk of hypotonic bleeding.

IMPORTANT! An alarming sign for hypotonic bleeding is more than 1 lining per hour.

If you go after a caesarean discharge with an unpleasant odor - seek help from your doctor.

Caesarean section is the most gentle method of delivery for a child. However, the operation does not exclude the possibility of the development of certain pathological conditions in the postoperative period.

In addition, for a uterus with a scar, the processes of involution (return to the prenatal state) proceed with some features than with delivery through the natural birth canal.

During operative delivery, the placenta is manually separated, in which the vessels of the placental site are exposed. Bloody discharge (lochia) in the first 3-4 days of the postpartum period is associated with the gradual healing (epithelialization) of the wound surface.

The volume of secretions in the first 3 days is about 250-300 ml. This is the most dangerous period.

But nature has created a defense mechanism. Despite the naked, "gaping" vessels, no infection occurs. This is due to the activation of granulocyte cells, macrophages at the site of the wound surface.

Like a barrier, these cells prevent the entry of infectious agents. This process is called "formation of a granulation shaft". Due to leukocyte cells, biologically active substances and proteolytic enzymes, the inner surface of the uterus remains sterile.

From the 4th day after the operation, the lochia acquire a lighter character, become serous-hemorrhagic, and become less abundant. They take on a brown tint. They contain significantly fewer erythrocytes than in the first days.

From the 10th day after cesarean, there are light discharges, only single erythrocytes are found in them.

By day 21, the nature of the discharge becomes mucous, transparent.

How long do withdrawals last?

6 weeks after the operation, the discharge becomes the same as before pregnancy. On average, for the entire postpartum period, the volume of lochia reaches 400-800 ml (with 80% of the discharge occurring in the first 3-4 days).

Pathological discharge after caesarean section

A change in volume, color, or the appearance of discharge with an odor is an important sign in the diagnosis of postoperative complications.

meager discharge

A decrease in the volume of lochia (especially in the early days) can occur for the following reasons:

Premature narrowing of the cervical canal leads to a violation of the outflow of secretions from the uterine cavity.
Planned caesarean section (lack of preparation of the birth canal, the cervix was completely closed by the time of the operation).
Violation of the contractile function of the uterus (there is no emptying of the uterus).
Refusal of breastfeeding (the process of feeding helps to reduce the muscle fibers of the uterus).

Clinical symptoms:

poor lochia in the first 3-4 days (less than 100 ml) is an unfavorable diagnostic sign;
temperature rise is possible;
pulling (possible even).

Diagnostic methods:

Examination on a gynecological chair to assess the patency of the cervical canal of the cervix.

Normally, in the postoperative period, the neck should pass one finger without difficulty. With a planned operation, there is a high probability of narrowing of the cervical canal and the development of a true hematometer (accumulation of blood in the uterine cavity).

Monitor the dynamics of uterine shrinkage (normally, every day the height of the uterine fundus decreases by 2 cm, if the outflow of secretions is disturbed, the process of uterine contraction can be slowed down).
Ultrasound (it is necessary to assess the uterine cavity: is there an expansion due to accumulated blood).

Too much discharge

Conditions leading to an increase in the volume of lochia:

remnants of decidual tissue in the uterine cavity.
violation of the blood coagulation system.
bleeding from a failed suture on the uterus after a caesarean section.
violation of the contractile function of the uterus.

Symptoms:

the volume of secretions in the first days exceeds 300 ml;
preservation of the bloody nature of the discharge for a long time (within two weeks);
pain not related to uterine contractions.

Diagnostics:

the size of the uterus does not correspond to the day of the postoperative period (the uterus is larger than normal);
copious discharge;
violation of the coagulation system in the analysis of the coagulogram;
ultrasound reveals an expansion of the uterine cavity, clots in the cavity, an inhomogeneous echogenic signal from the suture area;
the cervical canal is not narrowed, the outflow is not difficult.

Discharge with clots

Reasons for these withdrawals:

violation of uterine contraction (prolonged accumulation of blood in the uterus leads to the formation of clots);
failure of the suture on the uterus;
tissue defect in the area of the postoperative suture.

Clinical picture:

discharge with blood clots;
the size of the uterus is larger than it should be;
constant pulling pains not associated with uterine contractions are possible.

Diagnostics:

On palpation of the contours of the uterus, the discrepancy between the height of the fundus of the uterus and the day of the postoperative period is determined.
Ultrasound: clots in the uterine cavity, expansion of the cavity, the niche of the scar on the uterus is heterogeneous.

Yellow highlights

The reasons:

Erased, abortive, mild form of endometritis.
Infection of the postoperative suture.
Metroendometritis.
The presence of a long anhydrous period (more than 12 hours) before a caesarean section.
Pathological blood loss during surgery, or initial anemia.
Hematoma in the area of the seam on the uterus.

Symptoms:

unpleasant smell lochia (sharp);
pulling pains in the lower abdomen;
rise in temperature is possible;
weakness, dizziness.

Diagnostics:

The uterus is enlarged.
Pulse increase.
Drawing pains in the lower abdomen.
Inflammatory changes in the blood (leukocytosis, ESR acceleration, shift of the leukocyte formula to the left).
With ultrasound - echo-positive signals in the area of the walls of the uterus (corresponding to the imposition of fibrin threads), an inhomogeneous signal in the area of \u200b\u200bthe suture, “niches”, a festering hematoma at the site of the scar are possible.

Purulent discharge

Possible reasons:

endometritis.
metroendometritis.
failure, suppuration of the seam.
parametritis.
postoperative adnexitis.
obstetric peritonitis.
sepsis.

Clinical manifestations:

purulent or, with a sharp, unpleasant putrefactive odor, abundant;
an increase in temperature to high numbers (39 and above);
chills;
weakness, dizziness;
increased sweating;
severe pain in the lower abdomen;
cardiopalmus.

Diagnostic criteria:

Sharp pain on palpation of the uterus and appendages.
The size of the uterus does not correspond to the period of the postoperative period.
Painful traction for the cervix.
Displacement of the pelvic organs relative to the midline (with parametritis).
Sharp pain in the area of the appendages (with adnexitis).
Severe inflammatory changes in the blood.
Tension of the abdominal muscles, positive peritoneal symptoms (with peritonitis).

According to ultrasound: the uterus is enlarged, the cavity is expanded, the structure of the myometrium is heterogeneous, "a niche in the scar area", a festering hematoma, or an infiltrate in the small pelvis can be visualized.

Hygiene measures after surgery

Compliance with the rules of hygiene is an important condition in the prevention of postoperative complications.

You must adhere to the following rules:

obligatory washing in the first days up to 2-3 times a day.

It is necessary to use gels for intimate hygiene, or baby soap. It is advisable to use soap without aromatic additives, fragrances;

change pads every 2-3 hours in the first days. Use pads with maximum absorbency;

In pharmacies, you can buy special postpartum pads, but if they are not available, you can use others (the main thing is that they absorb discharge well).

change underwear frequently. You can use disposable panties.

Important conditions for the physiological course of the postpartum period are:

in the early days, put a cold load on the uterus, which contributes to its contraction and emptying of blood clots;
breastfeeding and milk expression contribute to the release of endogenous oxytocin. This hormone causes contraction of the smooth muscles of the uterus, which also contributes to the normal discharge of lochia;
prevention of infectious complications after surgery (prescription of broad-spectrum antibiotics);
From day 3, it is recommended to lie on your stomach more often. This position contributes to the deviation of the uterus, alignment of the cervical canal, which contributes to the discharge of lochia.

case from practice
A 28-year-old patient was hospitalized at the 39th week of pregnancy in the birth. house for a planned caesarean section (for placenta previa). During the operation, after the removal of the child and removal of the placenta, the patency of the cervical canal was checked (it freely passes one finger).

In the postoperative period, it was diagnosed: on the 3rd day, extremely scanty bloody discharge, the patient complains of nagging pain, the size of the uterus exceeds normal.

When viewed on a gynecological chair: palpation of the uterus reveals soreness, the uterus is larger than normal, the cervical canal is closed and does not allow a finger to pass through, spasm at the level of the internal os.

Ultrasound: in the uterine cavity blood in a volume of 100 ml.

Diagnosis: hematometra (accumulation of blood in the uterine cavity).

It was decided to restore the patency of the cervical canal using bougienage (expansion) to ensure a normal outflow of secretions.

The further postoperative period proceeded without complications. The patient was discharged on the 9th day in a satisfactory condition.

Operative delivery creates additional risks in the development of postpartum complications. The suture on the uterus prevents the full contraction of the uterus, with inflammatory processes, the infection spreads not only in the mucous membrane, but also in all layers of the uterus.

These factors impede the normal outflow of lochia, create favorable conditions for the reproduction of microorganisms. It is for these reasons that it is very important to closely monitor the discharge in the postoperative period, as well as observe the necessary rules of hygiene.

The involution of the pelvic organs and the birth canal after caesarean section takes longer than after natural childbirth. Because of the seam on the wall, the uterus contracts less. For this reason, discharge after caesarean section has some features.

All the difficulties of the postpartum period after caesarean section indicate that a woman needs to carefully monitor the amount, color changes and smell of lochia.

After separation of the placenta in the uterus, an open wound surface is formed at the site of its attachment. Blood vessels bleed very heavily in the first days after childbirth. Lochia is aggravated during walking, changing position and physical activity.

In the first 2-3 days, the discharge is very abundant, up to 150-200 ml per day. Bloody, scarlet in color with clots.
After 1 week, the lochia become sanious, brown-brown.
After 2 weeks, the volume of lochia decreases. In color, they turn brown with an admixture of mucus.
After 5 weeks, the lochia gradually disappears. Smearing yellow-mustard color.
After a month and a half, the discharge becomes transparent or white. At this time, a woman needs to visit a gynecologist. Undergo a gynecological examination and choose a method of protection.

In place of the wound surface, the growth of leukocytes, granulocytes, macrophages is activated. These cells become a protective barrier against infection and inflammation. Thanks to this natural defense mechanism, the uterine cavity remains sterile in the first days after childbirth.

When to See a Doctor

A woman after CS should especially monitor the amount, color and smell of postpartum discharge. And if some features are found, then you need to see a doctor so as not to start the inflammatory process.

Here's what to look out for:

If the discharge in the first days after childbirth is too scarce (less than 100 ml per day). This happens after elective CS operations, when the cervix was not ajar at the time of delivery. Therefore, the uterus is poorly emptied and postpartum lochia lingers inside. It is necessary to undergo an examination by a gynecologist, to check whether the cervical canal is dilated, whether there are blood clots in the uterine cavity.
If the discharge is too profuse (more than 300 ml), or the lochia is bloody and scarlet for more than 2 weeks. This may be due to a violation of blood clotting, rupture of the suture on the uterus.
If the lochia after caesarean section stopped earlier than after 3 weeks. This situation is fraught with the fact that blood clots remain in the uterine cavity. They can lead to an inflammatory process. Too long postpartum discharge (longer than 10 weeks) also does not mean anything good. This may indicate a protracted inflammatory process.
If the discharge has impurities of pus at any time of postpartum recovery. This may mean that an acute infectious and inflammatory process develops in the uterine cavity, endometritis or suppuration of the suture on the uterine stack. It is urgent to consult a doctor if the body temperature is above 39 degrees, palpation pain in the lower abdomen.
If the discharge is white curdled, then this indicates thrush, dysbacteriosis. Which often occurs after antibiotic therapy, which is carried out after a caesarean section.

Hygiene after caesarean section

Compliance with the rules of personal hygiene will help to avoid complications associated with postpartum discharge. And the knowledge of what contributes to the active cleansing of the uterus will help get rid of lochia.

Wash yourself after every visit to the toilet using an intimate hygiene product.

Change pads every 2-3 hours. First use postpartum pads for the first few days.

HB contributes to the rapid removal of lochia from the uterus due to oxytocin, which is released during sucking.

During movement, the uterus contracts more actively. Therefore, after a caesarean section, it is recommended to get up as early as possible and move from the first day after the operation.

The outflow of lochia after a caesarean section is slower than after a natural birth. This creates favorable conditions for the reproduction of pathogenic bacteria in the uterine cavity. Therefore, you need to carefully monitor how long the discharge after cesarean section lasts, and what character they have.

In addition, for a uterus with a scar, the processes of involution (return to the prenatal state) proceed with some features than with delivery through the natural birth canal.

What should be the discharge after cesarean: a little physiology

The volume of secretions in the first 3 days is about 250-300 ml. This is the most dangerous period.

But nature has created a defense mechanism. Despite the naked, "gaping" vessels, no infection occurs. This is due to the activation of granulocyte cells, macrophages at the site of the wound surface.

From the 10th day after cesarean, there are light discharges, only single erythrocytes are found in them.

By day 21, the nature of the discharge becomes mucous, transparent.

How long do withdrawals last?

Pathological discharge after caesarean section

A change in volume, color, or the appearance of discharge with an odor is an important sign in the diagnosis of postoperative complications.

meager discharge

A decrease in the volume of lochia (especially in the early days) can occur for the following reasons:

Premature narrowing of the cervical canal leads to a violation of the outflow of secretions from the uterine cavity.
Planned caesarean section (lack of preparation of the birth canal, the cervix was completely closed by the time of the operation).
Violation of the contractile function of the uterus (there is no emptying of the uterus).
Refusal of breastfeeding (the process of feeding helps to reduce the muscle fibers of the uterus).

Clinical symptoms:

meager lochia in the first 3-4 days (less than 100 ml) is an unfavorable diagnostic sign;
temperature rise is possible;
pulling (even arching pains in the lower abdomen are possible).

Diagnostic methods:

Examination on a gynecological chair to assess the patency of the cervical canal of the cervix.

Monitor the dynamics of uterine shrinkage (normally, every day the height of the uterine fundus decreases by 2 cm, if the outflow of secretions is disturbed, the process of uterine contraction can be slowed down).
Ultrasound (it is necessary to assess the uterine cavity: is there an expansion due to accumulated blood).

Too much discharge

Conditions leading to an increase in the volume of lochia:

remnants of decidual tissue in the uterine cavity.
violation of the blood coagulation system.
bleeding from a failed suture on the uterus after a caesarean section.
violation of the contractile function of the uterus.

Symptoms:

the volume of secretions in the first days exceeds 300 ml;
preservation of the bloody nature of the discharge for a long time (within two weeks);
pain not related to uterine contractions.

Diagnostics:

the size of the uterus does not correspond to the day of the postoperative period (the uterus is larger than normal);
copious discharge;
violation of the coagulation system in the analysis of the coagulogram;
ultrasound reveals an expansion of the uterine cavity, clots in the cavity, an inhomogeneous echogenic signal from the suture area;
the cervical canal is not narrowed, the outflow is not difficult.

Discharge with clots

Reasons for these withdrawals:

violation of uterine contraction (prolonged accumulation of blood in the uterus leads to the formation of clots);
failure of the suture on the uterus;
tissue defect in the area of the postoperative suture.

Clinical picture:

discharge with blood clots;
the size of the uterus is larger than it should be;
constant pulling pains not associated with uterine contractions are possible.

Diagnostics:

On palpation of the contours of the uterus, the discrepancy between the height of the fundus of the uterus and the day of the postoperative period is determined.
Ultrasound: clots in the uterine cavity, expansion of the cavity, the niche of the scar on the uterus is heterogeneous.

Yellow highlights

Erased, abortive, mild form of endometritis.
Infection of the postoperative suture.
Metroendometritis.
The presence of a long anhydrous period (more than 12 hours) before a caesarean section.
Pathological blood loss during surgery, or initial anemia.
Hematoma in the area of the seam on the uterus.

Symptoms:

yellow or yellow-brown discharge;
unpleasant smell lochia (sharp);
pulling pains in the lower abdomen;
rise in temperature is possible;
weakness, dizziness.

Diagnostics:

The uterus is enlarged.
Pulse increase.
Drawing pains in the lower abdomen.
Inflammatory changes in the blood (leukocytosis, ESR acceleration, shift of the leukocyte formula to the left).
With ultrasound - echo-positive signals in the area of the walls of the uterus (corresponding to the imposition of fibrin threads), an inhomogeneous signal in the area of \u200b\u200bthe suture, “niches”, a festering hematoma at the site of the scar are possible.

Purulent discharge

Possible reasons:

endometritis.
metroendometritis.
failure, suppuration of the seam.
parametritis.
postoperative adnexitis.
obstetric peritonitis.
sepsis.

Clinical manifestations:

purulent or green discharge, with a sharp, unpleasant putrid odor, profuse;
an increase in temperature to high numbers (39 and above);
chills;
weakness, dizziness;
increased sweating;
severe pain in the lower abdomen;
cardiopalmus.

Diagnostic criteria:

Sharp pain on palpation of the uterus and appendages.
The size of the uterus does not correspond to the period of the postoperative period.
Painful traction for the cervix.
Displacement of the pelvic organs relative to the midline (with parametritis).
Sharp pain in the area of the appendages (with adnexitis).
Severe inflammatory changes in the blood.
Tension of the abdominal muscles, positive peritoneal symptoms (with peritonitis).

Hygiene measures after surgery

Compliance with the rules of hygiene is an important condition in the prevention of postoperative complications.

You must adhere to the following rules:

obligatory washing in the first days up to 2-3 times a day.

It is necessary to use gels for intimate hygiene, or baby soap. It is advisable to use soap without aromatic additives, fragrances;

change pads every 2-3 hours in the first days. Use pads with maximum absorbency;

In pharmacies, you can buy special postpartum pads, but if they are not available, you can use others (the main thing is that they absorb discharge well).

change underwear frequently. You can use disposable panties.

Important conditions for the physiological course of the postpartum period are:

in the early days, put a cold load on the uterus, which contributes to its contraction and emptying of blood clots;
breastfeeding and milk expression contribute to the release of endogenous oxytocin. This hormone causes contraction of the smooth muscles of the uterus, which also contributes to the normal discharge of lochia;
prevention of infectious complications after surgery (prescription of broad-spectrum antibiotics);
From day 3, it is recommended to lie on your stomach more often. This position contributes to the deviation of the uterus, alignment of the cervical canal, which contributes to the discharge of lochia.

case from practice

A 28-year-old patient was hospitalized at the 39th week of pregnancy in the birth. house for a planned caesarean section (for placenta previa). During the operation, after the removal of the child and removal of the placenta, the patency of the cervical canal was checked (it freely passes one finger).

In the postoperative period, it was diagnosed: on the 3rd day, extremely scanty bloody discharge, the patient complains of nagging pain, the size of the uterus exceeds normal.

When viewed on a gynecological chair: palpation of the uterus reveals soreness, the uterus is larger than normal, the cervical canal is closed and does not allow a finger to pass through, spasm at the level of the internal os.

Ultrasound: in the uterine cavity blood in a volume of 100 ml.

Diagnosis: hematometra (accumulation of blood in the uterine cavity).

It was decided to restore the patency of the cervical canal using bougienage (expansion) to ensure a normal outflow of secretions.

The further postoperative period proceeded without complications. The patient was discharged on the 9th day in a satisfactory condition.

Distinctive features
Timing
Lochia character
Hue
Quantity

Regardless of how the birth occurred (with the help of surgery or naturally), the inner lining (lining) of the uterus needs a recovery period. It takes about 5-9 weeks if everything goes without complications.

Of particular note are the discharge after cesarean from the genital tract. They are called lochia in gynecology. They include blood cells, plasma, mucus, dead epithelium. For many women, they are perceived as a kind of menstruation. However, their color palette, smell, composition, volume change during the postpartum period and signal whether the young mother has everything in order with her body.

Distinctive features

Any operation, like the birth itself, is a serious stress for the body that is tired after pregnancy. Therefore, a woman needs to listen to him sensitively, feel the slightest deviations and know what the discharge after a cesarean section should be and what is considered the norm. This will allow her to notice alarming signals in a timely manner and be treated if necessary. Many sources indicate that lochia after CS is no different from those that come after natural childbirth. In fact, this is far from the case. Differences still exist.

The wound surface is much more extensive after cesarean, so the risk of infection or inflammation of the genital organs is very high. So during the discharge after the operation, it is necessary to carefully carry out all the prescribed hygiene procedures and not once a day.
At the very beginning, just after cesarean, about 5-7 days, the discharge is not only bloody in nature, but also contains a lot of mucus, which is not observed after natural delivery.
The normal color of the discharge after a caesarean section for several days is bright red, rich scarlet, and it is much juicier than during the natural process of childbirth.
The contraction of the uterus and its healing after cesarean is a longer and more protracted process, so the duration of the discharge is also different and is 1-2 weeks longer.

These differences should not frighten and disturb a young, perhaps not yet experienced mother in such matters, since this is the norm of discharge after a cesarean, which indicates that everything is in order. But in order to see something was wrong in time, you need to know about deviations, with which you will first have to contact specialists. Usually they differ little from problematic lochia after natural childbirth.

Timing

One of the most exciting questions is how long the discharge after a cesarean section lasts, in order to know for sure whether the recovery period has dragged on or the process is going within the allowed limits. Information about the terms that fit into the norm will allow you to control the real menstrual cycle, which should soon improve.

Norm

The discharge rate after caesarean section is from 7 to 9 weeks. So discharge 2 months after cesarean does not pose any danger to the health of a young mother.

Deviations

If after a cesarean the discharge ended too quickly (within 6 weeks) or was very long (up to 10 weeks), this is not a reason to panic. Yes, the limits of the norm are no longer observed, but these indicators can be determined only by the individual characteristics of the organism. If at the same time the composition, smell, density, color, number of lochia do not indicate complications, you should not worry. Although even in this situation, it will not hurt to inform the doctor about this.

Pathologies

A visit to the doctor is mandatory if the duration of discharge in the postpartum period after cesarean has gone beyond the norm. This is either too fast an end (less than 5 weeks), or too long a process (over 10 weeks). Both are equally dangerous. In the first case, the remnants of the dead endometrium, for some reason, could not come out and there is a high probability of their suppuration. With too long lochia, endometritis or an infectious process in the abdominal cavity or genitals can be diagnosed. The condition is also dangerous when the discharge after cesarean ended and started again: this also indicates some deviations in the process of restoring the uterus.

Knowing how much discharge goes after a caesarean section with a normal healing process, a woman may not worry that this period has been very long for her or, on the contrary, has passed too quickly. After all, in both cases, you will have to take appropriate measures: go to the doctor, undergo additional examinations and, if diseases or complications are detected, undergo a course of treatment, no matter how much you want it.

be careful. You should not rejoice if your discharge has already stopped a month after cesarean. Such a rapid process very often ends in inflammation or infection, which require surgical cleaning of the uterus.

Lochia character

Throughout the recovery period after surgery, the nature of the lochia will change. Initially, blood clots will depart, since the uterus at this time is a vast, open, bleeding wound. But over time, in the process of healing, they will change into mucus, dead epithelial cells and other postpartum debris.

This also needs to be monitored very carefully. If, for example, bloody discharge after cesarean does not end in any way, this will be an alarming signal that damaged tissues cannot be regenerated for some reason. Such cases require medical intervention and treatment. Therefore, watch the nature of your lochia and their duration.

Presence of blood

The presence of blood in the lochia at first should not raise doubts among young mothers: it is the bursting of blood vessels and damaged tissues that heal. However, the important point here is precisely the timing of how many days bloody discharge occurs after a cesarean: if more than 7-8, then this is already abnormal and you need to sound the alarm.

The presence of clots

It is also quite understandable in this period of time: they are cells of already dead endometrium and placenta. Already after 7-8 days they will leave, so that the discharge will become more liquid.

Mucous discharge

If mucous secretions have also been added to the bloody ones in the first days after cesarean, this is also the norm: in this way the body is cleansed of the products of intrauterine vital activity of the baby.

pink discharge

If pink discharge begins a month after cesarean, it means that the healing process has not yet been completed. Perhaps, under some mechanical influence, the injured tissues were again damaged. Very often this happens if a couple is impatient and, without waiting for the end of the recovery period, they start having sex too early.

brown shade

After 6-7 weeks, by their nature, lochia will resemble ordinary brownish menstrual smears: the blood will clot and will no longer be so bright and scarlet.

Purulent discharge

The danger after cesarean is purulent discharge, which is the first symptom of the endometrium (inflammation of the uterine mucosa). They are usually yellowish-green in color, smell very bad, and are accompanied by fever (due to infection), pain in the abdomen and perineum.

watery lochia

Should alert the young mother and watery lochia, devoid of any shade, almost transparent. So a transudate can come out - a fluid contained in the blood or lymphatic vessels. This is bad, as it indicates a violation of blood circulation in this area. In addition, watery discharge after cesarean with an unpleasant odor reeking of rotten fish is a symptom characteristic of vaginal dysbacteriosis (gardnerellosis).

If you had to give birth by cesarean, you must definitely monitor the nature of the discharge that has begun. It is the impurities in their composition that may indicate a particular disease that will need to be identified and treated. Often, all this threatens again with hospital walls - and this is precisely at the moment when a mother needs her baby so much. It is much easier to prevent the problem and enjoy the unforgettable moments of communication with the baby. In addition to character, the color of the discharge can tell a lot.

Hue

Normally, the color of lochia after cesarean should be red at first, then there are already brown discharges (towards the end). The rest of the color palette should alert the young mother and force her to go to the hospital for an additional examination to find out if everything is in order with her body recovery.

Yellowness

If yellow discharge begins after cesarean, they may indicate the following postpartum processes:

pale yellow, meager lochia by the end of 2-3 weeks is the norm;
bright yellow, almost orange discharge with a greenish tint, putrid odor on days 4-6 - a symptom of a pronounced, but just beginning endometritis;
copious, mucous, yellow discharge after 2 weeks is a sign of an already hidden and, most likely, advanced endometritis.

Endometritis cannot be treated on its own: antibiotic therapy or even surgery will be required.

Greens

It is not difficult to guess that the green discharge that began after cesarean is explained by the presence of pus in them. It indicates the course of an infectious, inflammatory process in the uterus. Only a medical examination will help determine its cause and diagnose the disease.

white lochia

By themselves, without accompanying symptoms, white discharge, which may begin some time after a cesarean, does not pose a threat. But as soon as certain signs appear, you need to be alert. These include:

itching of the perineum;
redness in the intimate area;
if there is a discharge with a sour smell;
curdled texture.

In such cases, a bacterial culture or vaginal swab is required for accurate diagnosis and appropriate treatment.

Black

If black discharge without odor or pain is observed after cesarean, they should be taken as the norm. They are dictated by hormonal changes in the blood after childbirth. A deviation is if they go some time after the operation.

To avoid complications of the recovery period after cesarean section, you need to monitor the color of postpartum discharge. It can suggest the problem that has arisen at the very initial stage. This will facilitate its elimination and will allow you to return to normal very quickly, having undergone the necessary course of treatment.

Quantity

A young mother also needs to pay attention to how many lochias come out of her in order to judge how the body is recovering. If there is little discharge after cesarean, especially in the very first days, this can be an alarm signal that the tubes, uterine ducts are clogged, a blood clot has formed, etc.

The opposite situation is no less dangerous: abundant lochia that does not stop for too long is an alarming signal about the impossibility of a full recovery of the uterus after surgery. In both cases, you need to undergo a special examination and find out what is the reason for such deviations.

Any woman wants postpartum lochia to end as soon as possible and nothing overshadows happy motherhood. However, one should not be too hostile towards them. It is they that can serve as that alarming and sometimes the only signal that not everything is in order with the restoration of the body and that some measures need to be taken to help it. Particularly, discharge after a caesarean section with a smell and an unrealistically bright shade should be alerted. This almost always ends with a course of antibiotic treatment, which is highly undesirable during lactation, or another surgical intervention.