Pregnancy and childbirth are complex physiological processes. But most women, in anticipation of the baby, have an idea of what they will experience in the near future. Now it’s not difficult to find information about how a baby develops in the womb by weeks, what to do for a safe pregnancy, how to prepare for childbirth. Preparation for a meeting with a little man so captures the expectant mother that issues of her own health recede into the background or do not fall into the field of her interests. Meanwhile, it is very important to imagine what are the complications after childbirth and factors predisposing to their occurrence.
Causes of complications after childbirth
The birth process takes place in two ways: through the natural birth canal and through the operation of a cesarean section. Childbirth is a powerful stress for the body that can trigger pathological processes. However, normally a woman’s body is reliably protected by the immune and hormonal systems. The prerequisites for the occurrence of complications after childbirth are:
• Hard birth
• Pregnancy Complications
• Weakened immunity
• Late toxicosis
• Complicated obstetric and gynecological history
• Intrauterine infection of the fetus
• The presence of genital infections in a woman in labor (candidiasis, chlamydia, herpes)
What are the complications after giving birth?
Localization distinguish:
• Local complications: endometritis, ulceration, mastitis;
• generalized: obstetric peritonitis, sepsis.
Postpartum Complications: Ulcer
Superficial damage to the mucous membrane of the perineum, vagina or cervix. To treat this complication that occurs after childbirth, it is advised to take air baths, leaving the surface of the wound as open as possible. This contributes to the drying and faster healing of the ulcer. If the wound began to suppurate, it should be washed several times a day with an antiseptic (furatsillin). In case of damage to the vaginal mucosa and cervix, disinfection syringes are performed. In the case of the spread of the pathological process, a visit to a doctor is strictly necessary, since the risk of generalizing the process increases significantly.
Endometritis - a common complication after childbirth
It is an inflammation of the uterine mucosa.
Mild endometritis develops 1-2 weeks after birth. There is a moderate increase in temperature to 38-38.5 ° C. The general health of the puerpera does not suffer much. A woman complains of prolonged spotting (lochia). In the blood test, an inflammatory process is indicated by an acceleration of ESR up to 35mm / h, a moderate increase in white blood cells.
Severe endometritis begins much earlier - 2-3 days after birth. Body temperature rises to 39 ° C, weakness, lethargy and loss of appetite are noted. In this case, the uterus is sharply painful: a woman feels a pulling pain in the lower abdomen, which increases significantly when the doctor tries to palpate the pelvic organs. Discharges from the genital tract become purulent, with a sharp unpleasant odor.
A particular form is endometritis against the background of a caesarean section. The disease is a frequent complication with this type of delivery.
Ultrasound of the pelvic organs is the "gold standard" in the diagnosis of endometritis. The method allows you to evaluate
• the size of the uterus and their compliance with the norms of this period;
• the presence of blood and purulent clots in the uterine cavity, fragments of the placenta;
• thickness of the endometrium and its uniformity;
• condition of the vessels of the uterus;
• consistency of sutures after cesarean section.
Treatment depends on the degree of the disease, the amount of pathological contents in the uterine cavity, and also on whether a woman is breastfeeding at the time of therapy. In the latter case, the doctor will try to choose a more gentle treatment option that will not affect lactation: the introduction of tampons with Vishnevsky ointment, intramuscular injections of scarlet, physiotherapy to the uterine projection area. Most often, this complex is enough, but only in the case of a mild course of endometritis.
With a severe degree of the disease, the use of antibiotics is mandatory, regardless of whether the woman is breastfeeding or not. Maternal health is a priority. Currently, there are antimicrobials that are acceptable for use during breastfeeding. Therefore, mommy will not have to wean the baby from the breast during treatment.
Rinsing the uterine cavity with an antiseptic solution may be required. The procedure is performed under anesthesia.
In order to restore immunity, a course of immunostimulants and immunomodulators and a complex of vitamins C and group B are prescribed.
Complications after childbirth: mastitis
This is an inflammation of the breast. The basis for the occurrence of mastitis is lactostasis - stagnation of milk in a nursing woman. This complication after childbirth is single and double-sided. The affected chest is painful, enlarged, hard and hot to the touch. In this case, an increase in body temperature to 38.5 ° C, chills, weakness is possible. In advanced cases, the process can go to axillary lymph nodes: they become inflamed, increase in size and become painful.
Ultrasound of the breast allows you to confirm the diagnosis.
With mastitis, antibiotics, bacteriophages, drugs for the correction of immunity are prescribed, in severe cases, hormonal anti-inflammatory drugs. The treatment is supplemented by physiotherapy methods: UV treatment, ultrasound, compresses. When inflammation of the mammary gland passes into the purulent stage, surgical intervention is required. The earlier it is done, the lower the risk of spreading the infection to other parts of the chest.
The opinions of doctors regarding the continuation of breastfeeding during the disease were divided. Nevertheless, it is better for the period of treatment to temporarily stop feeding and express stagnant milk. Then analyze the milk for sterility and, in case of a positive result, resume breastfeeding. This is done to prevent infection of the baby.
Sepsis - a dangerous complication after childbirth
Normal blood is a sterile fluid. In the case of a generalization of the process, blood is infected and microorganisms with its current spread throughout the body. This is a formidable complication with a possible fatal outcome.
Signs of complications:
• the presence of the primary focus - any local inflammatory process can cause sepsis with untimely treatment or depletion of the immune system;
• heat;
• detection of pathological microorganisms in the blood.
The puerperal consciousness can be impaired from lethargy and lethargy to precoma. There are tachycardia, rapid breathing, a decrease in the frequency and quantity of urination, blueness or pallor of the skin, and a decrease in blood pressure.
The principle of treatment for sepsis is the successful treatment of the primary inflammatory focus (uterus, mammary gland). Treatment is carried out by prescribing strong antibiotics, infusion therapy, antihistamines, hormonal anti-inflammatory drugs.
Antibiotics are used for 2-3 weeks, are selected according to their sensitivity to the microorganism that is found in the patient’s blood. Perhaps the simultaneous appointment of two to three drugs.
Terrible complication after childbirth: peritonitis
It is characterized by inflammation of the peritoneum. Peritonitis is a consequence of a localized pathological process: it can develop on the basis of endometritis or after cesarean section surgery. In these cases, a favorable environment for microorganisms is created in the uterus: an unhealed wound surface, dilated blood vessels, and blood clots. Since blood supply is increased after birth in the pelvic organs, microbes are quickly carried by the blood stream. Therefore, in recent years, Caesarean section, which has become fashionable, has received strict indications for conducting.
The symptomatology of peritonitis is bright and develops in 2-3 days. Characteristic: fever, thirst, dry mucous membranes, weakness, tachycardia, abdominal muscle tension when trying to touch. Later vomiting, loose stools join. In a general blood test, an increase in the number of leukocytes is observed.
In mild cases, complex antimicrobial treatment is performed. If the condition worsens, surgical intervention of various volumes may be required depending on organ damage: removal of the uterus and appendages from the tubes; drainage of the abdomen and the infusion of antibiotic solutions.
What complications after childbirth should be known to any woman preparing for the birth of a child. This knowledge will make her more sensitive to her health, treat possible diseases and infections, if any, that is, in time to prevent the complications that may occur after childbirth.
