Synonyms in the broadest sense
- Postpartum bleeding
- Uterine involution disorders
- Subinvolutio uteri
- Congestion of the weekly river
- Lochial damming
- Lochiometra
- Inflammation of the uterus in the postpartum
- Birth
The morbid puerperium bed
During the postpartum period, some complications can arise during the postpartum body and psyche repositioning processes after birth.
Increased bleeding and bleeding disorders
If the postpartum flow is excessive, it may be bleeding from a wound from a (possibly undetected) vaginal, cervical or perineal tear (lacerations of the vagina, cervix or perineum). The blood is bright red. The bleeding may also be due to inadequate afterpains (contractions of the myometrium) and no compression of the vessels of the endometrium.
Another reason may be trauma in the sense of an injury to the uterus during the birth process. Remains of the placenta in the uterus can also lead to bleeding. Bleeding disorders can occur during and after childbirth, especially in non-nursing mothers when the menstrual cycle is trying to return. If these bleeding disorders last longer and cause discomfort, they can be controlled with oral contraceptives.
Disorders of uterine regression (uterine involution disorders = subinvolutio uteri)
One speaks of a uterine dysplasia if the fundus (upper part of the uterus) does not sink by one transverse finger every day and the uterus is therefore not reduced in size according to the time. The reason may be reduced afterpains (uterine contractions). Diminished afterpains may be caused by benign muscular growths in the uterus (myomas) or due to congenital or acquired muscular weakness in the uterus (hypometrium).
Acquired muscle weakness is present, for example, in multiparous women. The afterpains can also be reduced in the case of overexpansion of the uterus in multiple births or if there is increased amniotic fluid (polyhydramion). Weaning also favors reduced afterpains.
Therapeutically, women who have recently given birth receive an ocytozin short infusion or ocytozin nasal spray, which promotes afterpains. A congestion of the postpartum flow can occur when the cervix is relocated. The transfer can be caused by blood coagulation or bending of the cervix when the uterus is facing backwards (retroflexio uteri).
Remaining eggshells can also cause the cervix to be displaced. The symptoms usually begin around the fourth to seventh day after delivery. It can be accompanied by high fever in the puerperium (> 38 degrees Celsius) and/or abdominal pain or pain in the puerperium.
However, non-specific and minor symptoms such as headaches or earaches may also predominate, which the women who have recently given birth misinterpret and do not consult their gynecologist. In any case, women who have recently given birth also notice a reduced or absent postpartum flow. If there is some postpartum, it smells quite bad.
Many women in childbed who have unspecific symptoms attribute the bad smelling postpartum to a lack of hygiene and try to improve their condition by increasing hygiene measures. However, this improvement does not occur because the lochia cannot drain off and more and more bacteria accumulate, which ultimately lead to an inflammation of the uterus (endo(myo)metritis) and in the worst case also of the fallopian tubes and ovaries (pelvic inflammatory disease). Therapeutically, an oxytocin short infusion or oxytocin nasal spray is given. The cervix (cervical canal) may be widened.
