Lochiometry is a complication that occurs after childbirth, characterized by the accumulation of lochiae in the uterus — a specific secret, the release of which occurs as a result of the birth process. It consists of mucus, blood and other physiological elements (decayed or reborn). To better understand the essence of this deviation, it is worth paying attention to the normal course of the postpartum process.
The content of the article:
Causes of the development of lochiometry
Symptoms of lochiometers
Diagnostics lochiometers
Complications of lochiometers
Treatment of lochiometers
Prevention and prognosis with a lochiometer
Lochiometer
After childbirth, blood clots and elements of the decidual membrane remain in the uterus (usually on its walls), which during pregnancy was responsible for fixing the embryo in the uterus. The granulation shaft, whose task is to separate living tissue from dead tissue, dilutes these residues by isolating a special enzyme. In addition, leukocytes, erythrocytes, as well as lymph and plasma enter the uterine cavity through the wound surface. This is how lochias are formed.
Normally, this secret is removed from the uterus naturally in a few weeks. Through the cervical canal, the lochia flow into the vagina, which is why the woman has secretions:
in the first 2-3 days — bloody;
on the 4th day — dark red or brown;
from the second week — light (under the influence of increased leukocyte levels).
Over time, the volume of secretions decreases, and after about three weeks they stop altogether. However, if there is no discharge, that is, lochiae remain in the uterine cavity, we are talking about the development of lochiometry.
Causes of the development of lochiometry
The main reason why the lochiometer develops, gynecologists call the insufficient ability of the uterus to contract. However, the outflow of lochia may not occur even in the presence of a mechanical obstacle. Thus, the factors that can provoke the development of lochiometry can be divided into two corresponding groups.
Factors of reducing uterine contractile activity:
excessive stretching of the organ (for example, due to the large size of the fetus or multiple pregnancies);
weak labor activity;
discoordinated labor activity;
spasm of the internal pharynx of the uterus;
caesarean section.
Factors that pose obstacles to the outflow of lochias:
inflection of the uterus;
blockage of the cervical canal.
In turn, the cervical canal may become clogged with fragments of the decidual membrane, exfoliating tissues of the uterine cavity or even blood clots.
In addition, since the lochiometer begins to develop about a week after childbirth, it can be provoked by excessively low activity of the woman in labor during the postpartum period (for example, prolonged bed rest).
Symptoms of lochiometers
The woman herself may find that the volume of discharge is too small — this is a good reason for the examination. Otherwise, the condition of the woman in labor does not change during the development of the lochiometer (temperature and pulse remain normal).
Upon examination, the gynecologist discovers that the uterus is enlarged in size. There is also pain during palpation examination of the organ. Often, in parallel with the lochiometer, endometritis develops — inflammation of the inner mucous layer of the uterus. This is explained by the fact that the composition of lochia is a favorable environment for the reproduction and vital activity of bacteria.
Separately, it is necessary to indicate the symptoms of a neglected lochiometer:
severe abdominal pain;
a jump in body temperature to 40 degrees;
the appearance of secretions with a specific odor;
chills and general malaise.
After a few days, the temperature drops sharply, and the discharge becomes purulent.
Diagnostics lochiometers
When contacting the hospital, the gynecologist first of all pays attention to the size of the uterus and its soreness. Ultrasound examination is used to get a more complete picture. It will show:
dense elastic consistency of the uterus;
uneven enlargement of the uterus;
the presence of blood in the uterine cavity (in a liquid state or in the form of clots).
Ultrasound can also reveal the inflection of the uterus or its internal pharynx closed due to spasm, which, as already mentioned, serve as a mechanical barrier to the outflow of lochiae.
Complications of lochiometers
In addition to the mentioned symptoms of a neglected lochiometer, which significantly worsens the condition of a woman, in extreme cases she can go into another disease. We are talking about pyometre — accumulation of pus in the uterine cavity.
The pain in the lower abdomen becomes cramping, the discharge becomes pus-like. A woman in labor with similar symptoms should be urgently hospitalized. In the hospital, the uterine cavity will be washed with antiseptic solutions.
Treatment of lochiometers
Treatment of lochiometry should ensure a normal outflow of postpartum secretions from the uterine cavity. This, in turn, means that the goal of treatment is to eliminate the obstacle to this very outflow.
If we are talking about a weak contractile ability of the uterus, then it needs to be activated. Usually, uterotonic drugs are prescribed for this woman in labor. It can be a solution of methylergometrine or oxytocin in the form of injections. To increase the effectiveness of treatment of lochiometers, it is recommended to accompany the course of these medications with injections of papaverine or no-shpa, which relieve spasms of the external pharynx of the uterus. Treatment with oral medications, such as stipticin, is also possible.
Taking medications is usually supplemented with ice compresses applied to the lower abdomen. In addition, it is useful for a woman to lie on her stomach for several hours a day.
If the reason for the inability to isolate the lochias was the inflection of the uterus, then a bimanual correction of this deviation is usually sufficient. Blockage of the cervical canal is cleared artificially. At the same time, the cervical canal expands forcibly.
There are cases when the listed methods of treatment lochiometers are ineffective. Then there is a need for surgical intervention. The contents of the uterine cavity are removed with a curette. In modern gynecology, the use of a vacuum apparatus with hysteroscopy for these purposes is more common.
Prevention and prognosis with a lochiometer
If the lochiometer was detected in a timely manner and received adequate treatment, it does not pose a threat to the woman’s health. However, you should beware of endometritis and the development of complications.
Preventive measures are aimed at maintaining normal contractile activity of the uterus:
lying on your stomach;
applying a hot water bottle with ice to the lower abdomen;
regular emptying of the intestines and bladder, which in a full state do not allow the uterus to contract sufficiently;
breast-feeding (when the nipples are irritated, an additional dose of oxytocin enters the body);
postpartum gymnastics.
Of course, you need to carefully monitor the volume of secretions and do not neglect medical examinations. Only a gynecologist can notice the enlargement of the uterus in time and determine its sensitivity by palpation. Also, the doctor should control the height of the bottom of the organ and its consistency.
