Postpartum uterine involution

Women should pay attention to body recovery after giving birth, and the body will also make some corresponding recovery functions. Uterine involution means that after a period of time after a woman has given birth, the uterus returns to its pre-delivery level. The uterine involution situation of each woman is different. Some women's uterus involution is the same as before, while some women's uterus involution is incomplete. So what methods should be used to solve the problem of incomplete uterine involution in women?

What is uterine involution?

After delivery, with a series of physiological changes, your uterus will gradually shrink, and the placental detachment surface in the uterine cavity will also shrink accordingly. Coupled with the regeneration of the endometrium itself, the uterus usually returns to a state close to that before pregnancy 5 to 6 weeks after delivery. This process is called uterine involution. During this period, if the process of uterine involution is prolonged due to some factors, it is called incomplete uterine involution.

Symptoms of incomplete uterine involution

The main symptoms of poor uterine involution are:

1. Prolonged lochia duration

The duration of bloody lochia is prolonged, exceeding 7 to 10 days or longer, and the amount increases significantly. The entire lochia lasted for more than a month.

2. Irregular or heavy vaginal bleeding

The flow of people has not been cleared for more than half a month. When infected, the lochia may be turbid, or have a foul odor and may be purulent.

3. Pelvic and lower back pain

Pain or heaviness in the pelvic area, heaviness or pain in the waist and abdomen, and some people also have back pain or unusual fatigue.

4. The uterus is large and soft or there is tenderness in the uterus

The uterus is larger and softer than the uterus in the postpartum period, mostly in a retroverted position, often with mild tenderness, and the cervix is ​​soft and may not close.

Causes of incomplete uterine involution

The causes of this complication are complex. The possible causes of incomplete uterine involution are as follows:

1. Part of the placenta and fetal membrane remain.

2. Endometritis, myometritis or other pelvic infections.

3. Due to the presence of uterine fibroids and uterine adenomyoma, the uterine involution function is impaired.

4. The uterus is excessively retroflexed or lateralized, and the lochia is not discharged smoothly, causing it to remain in the uterine cavity.

5. Excessive placental area or abnormal placental conditions (such as multiple pregnancy, placenta previa, etc.) affect uterine involution. These conditions make the muscle layer at the placenta attachment site thinner and the uterine contraction ability weakened.

6. The uterine muscle fibers of women who have given birth multiple times have been stretched multiple times and recover more slowly, which may affect uterine contractions.

7. Over-inflation of the bladder or the bladder being in a frequently inflated state affects uterine contraction. Postpartum urinary retention is one of the common causes.

What to do if the uterus is not involution

1. Massage the uterus

The recovery of the uterus depends on contraction, and the contraction of the uterus depends on natural mechanisms. That is, after the start of labor, the uterus will continue to contract, emptying again and again so that there are no gaps in the uterine cavity. The purpose of the mother massaging the uterus is to guide the uterus to continue to contract until there is no bleeding and the uterine cavity remains empty.

2. Chinese and Western medicine uterine contraction agents

To prevent heavy bleeding after delivery, doctors usually prescribe uterotonics. The uterus naturally has a mechanism to contract and expel blood. If you find that you have excessive postpartum bleeding, using a uterine contraction agent is the best option because it will work faster. Commonly used drugs include intramuscular injection of oxytocin or ergonovine.

3. Shenghua Tang

The ingredients of Shenghua Tang itself have the effect of removing blood stasis and replenishing blood in traditional Chinese medicine. After the blood stasis (blood clots) are removed, the uterus will naturally contract. Therefore, Shenghua Tang is more suitable for health care during the postpartum period.

In medical practice, contractants are mainly used to prevent postpartum hemorrhage, while Shenghua Tang has a significant effect in helping the uterus recover during the postpartum period. However, we need to analyze the specific situation. Poor postpartum uterine involution is a big problem. We must go to the hospital for examination, listen to the doctor's advice, and prescribe the right medicine.

4. Symptomatic treatment

(1) When incomplete uterine involution is confirmed to be caused by partial placental retention or most fetal membrane retention, it is often accompanied by mild infection of the endometrium and/or myometrium. Therefore, cephalexin 1g and metronidazole 0.2g should be taken orally 4 times a day for 2 consecutive days before performing curettage to avoid the spread of infection. The residual tissue and uterine decidua should be scraped off completely and thoroughly to achieve the dual purpose of hemostasis and pathological examination. Attention should also be paid to excluding uterine choriocarcinoma. After the operation, uterotonic agents should be given to promote uterine contraction, and broad-spectrum antibiotics should be continued for 1 to 2 days. It can also promote uterine contraction.

(2) For intramural fibroids of the uterus, uterine contraction agents are mainly used. If there is no significant effect after several days of treatment and vaginal bleeding continues to be heavy, hysterectomy should be considered.