Subinvolution of the uterus after childbirth - beware, endometritis! Subinvolution of the uterus: signs, diagnosis and treatment What is the danger of subinvolution of the uterus after childbirth.

The first thing that should alert a woman is persistent heavy bleeding of a dark (brown) color and often an unpleasant odor that does not stop after a few days after childbirth. Remember that normally, vaginal discharge from 3-4 days should brighten and begin to decrease significantly, gradually approaching the ichor in its state.

Another symptom of subinvolution can be slightly elevated (37-37.5 gr.) body temperature, signaling the presence of an inflammatory process, and a periodic increase in heart rate.

You should also pay attention to absence of cramping pains in the uterus during feeding or movements, since it is these pains that are evidence that the woman's uterus is successfully contracting, restoring its tissues and muscle tone.

In the presence of at least one of the listed symptoms, and even more so, several at once, it is necessary, as soon as possible, go to the doctor. An experienced gynecologist will be able to detect subinvolution as early as 2-3 days, even during the initial examination. To clarify the diagnosis after examination, as a rule, ultrasound is prescribed, and if there are good reasons, and hysteroscopy, which will allow not only to objectively assess the condition of the uterus, but also to analyze its contents.

Why subinvolution of the uterus can occur

The causes of a weakened (compared to normal) uterine contraction after childbirth are divided into two main groups.

infectious causes due to inflammation:

• against the background of a chronic disease already existing in a woman (pyelonephritis, anemia, STDs, etc.);
• against the background of the presence of bacterial and viral pathologies;
• against the background of infection during childbirth (abortion, diagnostic curettage);
• against the background of the fact that pieces of the placenta or membranes could be left in the uterine cavity.

Causes of true uterine subinvolutions are usually associated with:

• with severe distension of the uterus due to a large fetus, multiple or polyhydramnios pregnancy;
• with rapid or, conversely, with prolonged childbirth;
• with childbirth by caesarean section;
• with adenomyosis (a disease when the endometrium is enclosed in the myometrium);
• with a woman's uterine myoma;
• with little physical activity after childbirth;
• with late toxicosis;
• with age childbirth (both in that and in the other direction).

Treatment of subinvolution of the uterus after childbirth

Before making specific appointments, the doctor determines the cause of subinvolution, since in different cases the treatment of this disease is carried out in different ways.

In the case of infectious-inflammatory subinvolution a course of antibiotic and antibacterial therapy is usually prescribed, which destroys the source of infection and eliminates the focus of inflammation. As a rule, together with this, drugs that thin the blood and improve blood circulation are also prescribed to relieve congestion in the pelvis.

If in the uterine cavity remnants of the placenta or amniotic sac are found, they must be removed, most often by vacuum cleaning, which is the most gentle procedure after childbirth. And the pathogenic flora and the remnants of lochia (postpartum secretions) are eliminated by washing with a cool saline solution. In addition, sometimes a special massage of the uterus and ovaries is prescribed.

When the cause of subinvolution became insufficient tone of the uterus, prescribe drugs that contribute to its increase and accelerate the process of contraction of the organ. These drugs (such as Oxytocin or various ergot preparations) tone the muscles and improve the elasticity of the uterine tissues. Another effective technique is novocaine and autohemotherapy.

In addition to the main purposes, phytopreparations are often used, for example, special teas from medicinal plants: shepherd's purse, nettle, yarrow and others. Also, to maintain the general tone, in addition to the basic treatment, general strengthening agents (vitamin-mineral complexes and intravenous glucose solution) can be prescribed.

Important! It should be remembered that the intensity of uterine contractions is greatly facilitated by the process of breastfeeding, since the hormone prolactin produced during this naturally causes the muscles to contract.

And, of course, no self-treatment in case of subinvolution it just shouldn't be. This is a serious condition that can lead to other problems later on, such as sepsis, endometritis, or loss of fertility.

Involution as a pathology

All signs of regression of the genital organs, diagnosed at 45-50 years old, are also characteristic of young women, when this phenomenon is considered pathological. Early extinction of the functionality of the appendages leads to the premature onset of menopause. Patients who come to the doctor with this problem usually complain about the impossibility of conception.

To prevent complete ovarian dysfunction, drugs containing estrogen and progesterone are prescribed. With their ineffectiveness, drug stimulation of ovulation is used. In extreme cases, conception occurs by artificial insemination.

Adnexal involution in reproductive age is rarely manifested by sweating, hot flashes, changes in blood pressure, and other symptoms. Women usually note only a deterioration in the condition of the skin, hair and nails, mood swings, a change in the nature of menstruation.

Forecast

The prognosis for the treatment of subinvolution is quite reassuring. If the doctor's instructions are followed correctly and detected in time, the woman will be able to overcome the pathology, and her uterus will return to normal size.

Reasons for the development of pathology

Subinvolution does not arise from scratch, it needs reasons for its development. They are divided into 2 groups, according to this principle, a complication of an infectious nature and a true one are distinguished. In the first case, a delay in the development of recovery processes can be caused by:

• intrauterine bacterial and viral pathologies;
• the transfer of pathogens into the genital tract of a woman during the process of childbirth;
• the appearance of an infection in the uterus due to pyelonephritis, anemia, and other pathologies of a young mother;
• retention in the cavity of the organ of particles of the placenta;
• a woman has a sexually transmitted infection.

In all cases, the presence of the pathogen only in the neck of the organ is sufficient to slow down its recovery. If it enters the uterus, subinvolution becomes even more pronounced.

Causes of true complication:

• increased stretching of the organ during pregnancy due to multiple pregnancy or polyhydramnios, bearing a large baby;
• fast delivery;
• long-lasting process of the appearance of a child;
• gynecological diseases that existed before pregnancy (myoma, adenomyosis);
• insufficient physical activity in the postpartum period;
• toxicosis in late pregnancy;
• giving birth at a too young or, conversely, no longer young age.

Separately, it is worth noting such a phenomenon as subinvolution of the uterus after cesarean section. The operation performed and normally slows down the recovery processes a little, since sutures remain on the organ and abdominal wall. They should tighten, but at the same time, a patch of scar tissue is formed that prevents the uterus from contracting. If problems begin with the healing of the suture, or the woman is too cautious in her movements, it is possible that the return of the uterus to its previous parameters and functions will be pathologically slowed down.

Risk factors

At risk are those women in labor who, before pregnancy, suffered from diseases that contribute to the development of postpartum subinvolution of the uterus.

• Diabetes 1 and 2 types;
• Obesity;
• Disease of the endocrine system;
• Vegetative-vascular dystonia;
• Varicose veins.

It also affects the development of the pathology of a gynecological disease:

• Anemia;
• Colpitis;
• Herpes;
• Ruptures of the cervix, vagina.

Often, doctors underestimate the problem of subinvolution, so women have severe complications. According to statistics, 2-10% of women who are not at risk suffer from this pathology. Women who have an infection in the birth canal suffer from subinvolution in 20% of cases. And those who give birth by cesarean section suffer from subinvolution in almost 35% of cases.

Treatment of blood clots in the uterus

If the diagnosis is confirmed, the woman is prescribed treatment depending on the form of the complication.

Antibacterial therapy

When establishing an infectious manifestation of a complication, antibacterial drugs are used.

It should be borne in mind that when feeding a baby, the list of medicines that can be used by a nursing woman is significantly reduced.

Usually, the doctor prescribes drugs from the group of semi-synthetic penicillins with an extended spectrum of action. In some cases, drugs of the cephalosporin group with metronidazole may be prescribed. It must be remembered that when using these drugs, breastfeeding is stopped for a while.

In the presence of a viral infection, the doctor may prescribe intramuscular infections with sinestrol, ergot, oxytocin drugs. In case of severe intoxication, colloidal blood substitutes (sodium chloride, magnesium chloride, calcium chloride) are used.

Drugs for the treatment of subinvolution - table

Medications for uterine contraction after childbirth - gallery

Analgin-Quinine helps to reduce pain, promotes uterine contraction after childbirth or abortion
Ergometrine is one of the main ergot alkaloids, which indicates a direct effect on the uterus and causes its persistent contraction.
Oxytocin is prescribed to contract the uterus to prevent postpartum hemorrhage.

Therapy with antibacterial drugs is carried out only according to the doctor's prescription in a strictly specified dosage.

If the pathology is caused by the initial signs of endometritis (inflammation of the inner layer of the uterus), the woman is prescribed blood-thinning drugs and drugs that improve blood circulation.

During the treatment, an ultrasound examination is performed on every third and last day.

Vacuum application

If the remains of the placenta, the fetal membrane are found in the uterine cavity, then against the background of antibiotic therapy, vacuum aspiration is performed using a vacuum pump and subsequent washing of the uterus with therapeutic solutions.

During the procedure, the external genitalia are treated with antiseptic preparations. A special tube is inserted into the uterine cavity, which is connected with a syringe or an electric aspirator. The specialist, rotating the catheter, clears the cavity of blood clots.

Vacuum aspiration is performed after childbirth to remove blood clots and other accumulations without damaging the neck of the organ and its walls

After vacuum aspiration, it is necessary to visit a gynecologist after two weeks.

If subinvolution is caused by mechanical action, the doctor may prescribe physiotherapy:

• magnetotherapy - with the help of a special apparatus, magnetic fields are exposed to certain parts of the body;
• electrical stimulation - the impact on the body of current pulses in order to restore weakened organs or systems.

Usually, recovery occurs on the 7-10th day, depending on the complexity of the complication and the individual characteristics of the woman's body.

Phytopreparations

In addition to the main method of treatment, the use of herbal teas is allowed. It should be borne in mind that the use of medicinal herbs is only an auxiliary method. It is strictly forbidden to take herbal remedies on your own, as this can cause negative manifestations and lead to a worsening of the course of the disease.

The following medicinal plants are most widely used:

• nettle;
• yarrow;
• horsetail;
• shepherd's bag.

Medicinal plants for the treatment of subinvolution - gallery

Nettle has a beneficial effect on the hormonal background, has a hemostatic effect.
Yarrow has an analgesic, hemostatic effect
Horsetail is taken as a hemostatic, wound healing, anti-inflammatory agent.
Shepherd's purse is recommended for menstrual cycle failures, as well as after childbirth, if heavy bleeding is observed.

An infusion is prepared from dry raw materials as follows: 4 tbsp. l. herbs are poured into 0.5 liters of boiling water and infused for 15-20 minutes. Take 100 ml 3 rubles / day for two weeks.

Self-medication is strictly prohibited. The use of medicinal herbs is possible only after consultation with your doctor.

Kinds

The division of subinvolution of the uterus into species is based on infection of the endometrium that occurred after childbirth. Therefore, there are primary and secondary types.

The primary type develops in the complete absence of inflammatory changes. It is observed quite rarely and occurs under the influence of such factors:

• myogenic, that is, muscle weakness after multiple pregnancy, polyhydramnios, rapid or prolonged labor;
• microcirculatory, that is, a violation of the blood supply to tissues, the release of fluid into the intercellular space and edema during preeclampsia;
• endocrine, associated with a violation of hormonal stimulation of myometrial contraction; in particular, subinvolution's own oxytocin may not be produced due to lack of breastfeeding.

Endometritis can be caused by viruses, bacteria, including those that normally exist on the surface of the genital organs and in the intestines (opportunistically pathogenic). The likelihood of this is especially high with a delay in the placenta, urinary tract infection. In such patients, subinvolution of the myometrium after childbirth should raise the mandatory suspicion of the development of postpartum endometritis.

Diagnostic methods

When managing pregnancy, the gynecologist may suggest the subsequent development of subinvolution of the uterus, highlighting a special risk group. It includes women with polyhydramnios, expecting twins or triplets, with infectious diseases, etc. They are recommended to pay special attention to women's health after childbirth, to regularly visit the local gynecologist.

It is possible to diagnose the initial stage of the disease as early as a week after childbirth. The ultrasound doctor should notice that the uterus is not contracting enough. Sometimes a specialist is able to suspect a pathology even before discharge from the hospital, 2-3 days after delivery.

The main diagnostic methods for suspected subinvolution:

• questioning the patient, analysis of complaints;
• examination on a gynecological chair (palpation reveals a loose structure of the uterus, its enlarged size);
• Ultrasound through the abdominal wall or vagina;
• MRI of the pelvic organs (allows you to accurately determine the presence of pathology);
• hysteroscopy (endoscopic examination of the uterine cavity with subsequent sampling of material for analysis);
• laboratory tests (general blood and urine tests, microbial culture of the vagina).

Another type of involution of the mammary glands

This variant of tissue changes in the breast in a woman is much less common than the one described above.

But still it has a place to be, so your education in this regard will not hurt. Fibrous involution is the replacement of glandular lobules in the mammary gland with connective tissue. At the same time, the appearance of fatty deposits was practically not detected. In this case, extensive areas of dense tissue of the connective type may remain in the chest. There are also fairly coarse fibrous bands.

The doctor examines the mammary glands for a long time, so as not to confuse the skin folds that appear in the sagging, flabby breast with fibrotic manifestations. Usually they should not cause alarm. Fibrous involution of the mammary glands is a natural process for women whose age has approached menopause. Otherwise, when the childbearing period continues, there is a serious reason for a visit to the doctor.

Clinical manifestations

The main signs of subinvolution of the uterus:

• delayed reduction in the size of the organ after childbirth;
• lochia lasting longer than 3 weeks;
• foul-smelling discharge (a sign of infection);
• lack of spasmodic sensations in the lower abdomen when breastfeeding or nipple stimulation;
• pulling pains in the lower abdomen without connection with external causes.

A long delay in postpartum discharge in the uterine cavity, or lochiometer, often causes the development of severe endometritis. This acute inflammatory process has characteristic symptoms:

• severe fever with chills, sweating, weakness;
• the allocation of lochia is not brown, but yellowish-greenish, purulent in nature, with an unpleasant odor;
• deterioration in general well-being;
• weakness, headache;
• abdominal pain.

Fibrofatty involution as the most common change in menopausal women

When women talk about such a condition in adulthood, when the process proceeds slowly, starting from the deep and lower parts of the breast and ending with its upper square, then this is the absolute norm of aging of her body. Another thing is when such changes are revealed during a thorough ultrasound and examination by a competent mammologist in young ladies who, as they say, are in their prime, are able to have children and must breastfeed them.

It is even sadder if the formations of this nature are focal. Naturally, it already makes sense to talk about some kind of pathology, hormonal failure and disruption in the work of the patient's endocrine system. It also makes sense for an adult woman to regularly consult a doctor when she was diagnosed with fibro-fatty involution in menopause. Two examinations a year will be enough to exclude the formation of benign and malignant tumors in the breast, which is why this age has been so dangerous lately for the entire female population.

To reduce the risk of complications after delivery, it is necessary to prepare the muscles of the vagina even at the stage of pregnancy planning.

Kegel exercises to strengthen the pelvic floor are considered an effective method of preventing subinvolution. With their help, you can prevent the prolapse of organs, as well as quickly restore the normal state of the uterus.

The essence of gymnastics is to alternately compress and relax the muscles of the pelvic floor. You can perform the exercises in any convenient place. The optimal frequency is 3-4 rubles / day from 5 to 10 seconds.

Video: Kegel exercises

After childbirth or caesarean section, it is necessary to start moving as soon as possible. The fact is that even a slight physical activity improves blood circulation in the pelvic organs, and also stimulates the fastest contraction of the uterus.

The impact of involution on the health of the whole organism

A negative impact on a woman's health occurs due to hormonal imbalance. The restructuring of the endocrine system provokes the following disorders and pathologies:

• diseases of the genitourinary system;
• decreased immunity;
• deterioration of the skin, hair and nails;
• osteoporosis - loss of bone density;
• arthritis and arthrosis;
• diseases of the cardiovascular system.

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Symptoms of the onset of menopause and the course of involution of the genital organs are different depending on the presence of concomitant diseases. At this time, a woman may have the following signs of menopause:

• weakness, malaise;
• drops in blood pressure;
• flushes of heat;
• sweating;
• aches in the joints;
• mood swings;
• headache;
• swelling of the legs;
• dryness in the vagina;
• insomnia;
• decreased libido.

These symptoms can be present until the complete end of the involutive changes in the ovaries and uterus - from 1 to 5 years. In some cases, menopause may last longer. Intense, persistent symptoms that reduce the patient's performance require therapy.

Possible Complications

Subinvolution of the uterus is a dangerous condition after childbirth. If left untreated, the following complications may occur:

• development of infertility;
• the appearance of a tumor in the uterus (myoma);
• endometriosis (pathological growth of organ tissues outside its limits);
• hyperplasia (growth of the mucous membrane of the uterus);
• blood poisoning;
• peritonitis (inflammation passes into the abdominal cavity).

This is not the whole list of life-threatening consequences of untreated subinvolution of the uterus. If there was no inflammation at the beginning of the disease, then it will appear later.

Changes in the internal genital organs after menopause

Against the background of a changing hormonal background, involutive changes occur both in the ovaries and in the uterus. This process is most active during the first years of the menopause period. Over time, the rate of extinction of the functions of the genital organs decreases. Stopping changes occurs when the menstrual cycle stops completely.

Changes in the uterus

The process of involution in the uterus is clearly visible on ultrasound. At the beginning of the menopause, deviations from the norm are insignificant. At the same time, there is a decrease in the volume of the organ, the thickness of its endometrium. In the future, the following signs of uterine dysfunction appear:

• local occurrence of myometrial fibrosis;
• reduction in the size of the organ - by 40% of the norm;
• deterioration of local blood supply;
• increased echogenicity of the organ;
• endometrial atrophy;
• narrowing of the cervical canal;
• accumulation of fluid in the uterine cavity - serometer.

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All these processes are fraught with the development of diseases of the body. Due to a decrease in blood supply and hormonal failure, there is a high probability of the formation of fibroids, polyps, benign pathologies, and the appearance of intermenstrual uterine bleeding. The latter may be a consequence of the course of uterine tumors, including malignant ones.

All atrophic changes are detected during ultrasound, dopplerometry. New growths that have appeared require additional types of examinations - CT or MRI of the uterus, tests for tumor markers, hormonal levels, diagnostic laparoscopy or puncture.

Ovarian disorders

Adnexal involution usually precedes similar changes in the uterus. At the same time, the following deviations in their structure and functionality are noted:

• size reduction;
• decreased endocrine function - manifested by low levels of estrogen and progesterone;
• change in echogenicity;
• indistinct boundaries of appendages;
• a small number of follicles in the first phase of the menstrual cycle;
• lack of ovulation;
• functional cysts.

Over time, the production of hormones by the ovaries becomes less intense. This entails more and more irregularities in the menstrual cycle. Periods come with a delay, then - every few months. The bleeding itself against the background of the absence of ovulation and a decrease in the thickness of the endometrium of the uterus becomes scarce.

Low levels of estrogen and progesterone provoke an increase in androgens and hormones from the pituitary and hypothalamus. Thus, the body tries to maintain the balance of the endocrine system. The hypothalamus is capable of producing female hormones, but to a much lesser extent than the ovaries.

In the process of involution, the risk of developing diseases of the appendages increases significantly. Most of all, at this time, organs are prone to damage by tumor-like formations that can degenerate into malignant ones. The main danger of such pathologies is a long asymptomatic course. Adnexal cancer is often detected already at stage 3, at which metastases spread throughout the body with a high probability.

Instrumental diagnosis of the ovaries in menopause can be difficult due to the course of adhesive processes in the pelvis, uterine prolapse, obesity and other pathologies.

In what cases it is necessary to see a doctor

If any unpleasant symptoms appear, a woman should immediately contact a gynecologist.

During the examination, the doctor may observe an enlarged uterus, which has a loose surface. On palpation, the woman feels pain. To clarify the diagnosis, an ultrasound examination is prescribed. The method allows to identify the presence of pathological inclusions, the nature of the complication, the size of the uterus.

If there is a suspicion of a delay in the recovery of the uterus after childbirth, an ultrasound examination is performed, as well as hysteroscopy and MRI

If necessary, appoint:

• MRI - allows you to examine the uterus from all sides at once, examine the walls of the organ and the endometrial layer;
• hysteroscopy - makes it possible to study the pathology of the inner layer of the uterus.

Three-dimensional image on the ultrasound machine allows you to see the subinvolution of the uterus on the 4th day after birth

Pathogenesis

In the development of postpartum uterine subinvolution and the addition of endometritis, three factors of pathogenesis are of primary importance:

1. Insufficient hormonal and nerve stimulation of the uterine muscle fibers

It leads to their overstretching and violation of contractility (ability to contract). An increase in intercellular spaces between stretched muscle fibers increases the area and depth of penetration of pathogens, which contributes to the development of infection.

1. Insufficient spasm of uterine vessels in the first days after childbirth

It causes swelling of tissues, their inflammation and the absence of normal contraction of the organ. The reason for this is foreign bodies in the uterine cavity (remnants of the endometrium). For example, this is how the subinvolution of the uterus develops after an abortion. Therefore, such a procedure is recommended to be performed by a qualified doctor with careful ultrasound control after it.

1. Tissue edema

It contributes to impaired blood supply, which slows down the physiological breakdown of connective tissue fibers located between muscle cells and preventing their normal size from returning.

Are there fat involutional changes?

Oh sure. In general, involution is a combination of two processes: fat and fibrous. In a healthy female body, they will proceed simultaneously. But there are cases when fatty involution prevails. Then, adipose tissue actively grows in the breasts of the female representatives between the glandular components, which will eventually replace these areas. Therefore, they say that after 40 years, the bust can become sagging, because the tissues become thinner. On your own, you are unlikely to detect such changes. They are visible only with the help of special medical equipment, with the simultaneous consultation of an experienced doctor in this matter.

Those places in the chest that have already undergone transformations will be quite light on the x-ray. Fat involution can be both a completely natural process and a serious problem. Here it is necessary to analyze several main points: did the woman give birth, what is her age, does she have hormonal problems and diseases of the endocrine system. Reliable answers to these questions will help the doctor to draw the right conclusions and, if necessary, prescribe competent treatment. The age of a woman as a whole is divided into three stages:

- from puberty to 45 years - the active phase, when healthy women have a childbearing function;

- from 45 to 50 years - the time of significant changes, when the menopause begins;

- after 50 years - the senile stage of development.

All this suggests that at the moment when the active phase prevails, a woman gives birth and breastfeeds, she simply should not face involutional changes. Later, this is considered the norm. Therefore, doctors strongly recommend that female representatives, who are used to carefully monitoring their health, examine this area of ​​\u200b\u200btheir body twice a year. Fat involution is not so dangerous if detected in the early stages of its development, since correctly prescribed drugs can regulate the hormonal background and stop this process.

Involution as a process taking place in the uterus - is it a disease?

No, this is a natural stage in this organ, which was conceived by Mother Nature herself. It can be divided into two types: postpartum and menopausal. In the first case, changes in the female body occur according to a certain schedule, that is, after the birth of a child, the uterus must restore its previous size. This lasts for about 2 months and occurs due to a decrease in the amount of certain hormones in a woman's body: progesterone, estrogen and oxytocin (which is produced during breastfeeding). Involution of the uterus after childbirth can be delayed or disrupted for several reasons:

- the number of births - the more there are, the longer this process;

- bearing twins or more fetuses;

- age after 30 years, in a woman who has given birth, the uterus contracts much more slowly;

– arising complications: inflammation, bleeding, etc.;

- lack of natural breastfeeding.

Also, involutional changes can cover the uterus of a woman whose childbearing age has come to an end (climacteric involution).

The danger of involutionary processes

In this situation, the doctor will always pay attention to the age of the woman who came to him for an examination. The patient must clearly understand that involution is a pathology only if she is young. And for ladies of mature age, whose reproductive function is completed, this is an absolutely natural process that prepares the body for menopause. The main task of a mammologist is to exclude any inflammatory diseases, as well as formations of a different nature. Therefore, the fair sex should take note of the scheme for visiting this specialist:

1. From the age of 36 - once a year.
2. After 50 years - 1 time in 1.5-2 years.

Causes of the pathological condition

Subinvolution of the uterus after childbirth can be due to such reasons:

• C-section;
• multiple pregnancy, accompanied by excessive stretching of muscle fibers;
• retention of parts of the placenta in the uterine cavity after childbirth, these fragments can also become the site of infection and the formation of postpartum endometritis;
• prolonged or rapid labor, depleting the contractility of the myometrium;
• secondary infection - endometritis.

More often than others, the disorder occurs in puerperas with fibromyoma, women younger than 18 or older than 40 years, in the absence of lactation, especially in the first days after childbirth. Also, diseases such as posthemorrhagic anemia, connective tissue diseases, abnormalities in the development of the uterus, digestive disorders with malabsorption syndrome, exhaustion, and severe chronic diseases, including tuberculosis, contribute to the weakening of the body and, as a result, to slowing down recovery.

Subinvolution of the uterus after caesarean section is not a pathological, but a physiological process. It is associated with delayed contraction and healing of the dissected muscles of the uterine wall. In this case, it is not recommended to use Oxytocin, therefore, antibiotics are prescribed without fail to prevent infectious complications.

Sometimes there is a false subinvolution if the measurement of the organ is performed with incomplete emptying of the bladder. Therefore, in the postpartum period, before a medical examination, you should urinate.

Currently, the main theory of the development of subinvolution of the uterus is infectious. Normally, it should decrease on its own, even in the presence of adverse factors. Subinvolution is considered as a risk factor or the first manifestation of endometritis.

Causes

The reasons for the development of subinvolution are divided into two groups. The first group is an infectious factor in the development of pathology. It includes the following manifestations:

• Inflammatory processes inside the womb;
• Entering the infection into the uterine cavity during the process of childbirth;
• The development of infection against the background of chronic diseases, such as pyelonephritis, anemia, inflammation of the appendages;
• Residual effects of the presence of the placenta in the pelvic organs;
• The presence of sexually transmitted diseases in the body of a woman.

If the infection is in the cervix, then this is already enough for the development of subinvolution. However, if the same infection enters the organ itself, then subinvolution develops in a rather acute form.

The second group of reasons is called true. It includes mechanical damage to the uterus caused by one or another phenomenon. For example:

• With a large fetus, stretching of the organ may develop (with multiple pregnancy and polyhydramnios);
• If the birth was fast;
• If on the contrary, the birth was very long;
• In case of a tumor in the uterus before pregnancy;
• Passivity in the physical plane after childbirth;
• If in the last months of pregnancy a woman suffered from toxicosis;
• Childbirth at a dangerous age: too early or late birth.

A separate reason for the development of subinvolution is the consequence of a caesarean section. Because of the operation, stitches remain on the uterus. Therefore, if a woman in labor has a problem with the healing of sutures, then she cannot avoid subinvolution of the uterus. The scar simply will not allow the muscle to fall into place.

Content

A woman after childbirth experiences not only emotional upheavals, but also physical ones. After all, the body of a newly-made mother is trying to restore strength and former functions, and the uterus - to return to normal size. But this process does not always take place within acceptable standards. In cases of impaired contraction of the organ, subinvolution of the uterus is diagnosed after delivery.

Characteristics of the complication

The healthy functioning of the uterus after delivery lies in its reverse development. The body of an organ undergoes:

• a significant reduction in parameters;
• change of location in the pelvis;
• restoration of the mucous membrane lining the inner surface of the organ;
• change in shape, it becomes pear-shaped.

Also important is the localization of the fundus of the uterus. After childbirth and the exit of the placenta, the uterine fundus is fixed in the navel, after a day it falls lower, and after four days - in the area between the womb and the navel.

The described processes represent involution - the natural reverse development of the uterus after childbirth. This physiological process normally lasts about two months.

Unfortunately, not all women in labor undergo involution. In such cases, subinvolution of the uterus is diagnosed. What is it?

- this is a pathological condition of an organ, in which there is a slowdown in its reverse development or fading.

Such a postpartum complication is expressed as follows:

• the process of reducing the body of the uterus is inhibited;
• the organ is practically not reduced;
• does not stop bleeding.

Recovery processes do not occur on time, which can provoke serious complications in the form of life-threatening bleeding.

Subinvolution can be diagnosed not only after childbirth, but also after a cesarean section, after a curettage. There is also subinvolution of the uterus after an abortion.

Manifestation and diagnosis of pathology

By the presence of specific signs, a woman can independently determine a postpartum complication. Subinvolution of the uterus is manifested by obvious symptoms.

• Abundant fresh bloody or brown discharge a few days after birth, often with an unpleasant odor. Normally, the amount of secretion should decrease, brighten and be similar to ichor.
• Elevated body temperature, indicating the presence of an inflammatory process. You may also experience an increased heart rate. The temperature may rise with swelling of the mammary glands when milk arrives.
• Bloody lochia (postpartum discharge) even after three weeks.
• The woman does not feel cramping pains in the abdomen. The absence of spasms indicates a weak uterine contraction.

An experienced doctor will be able to establish an incorrect uterine contraction already on the second day after delivery. To accurately determine that this is a subinvolution of the uterus, the following diagnostic methods are used.

1. Palpation of the fundus of the uterus. The gynecologist during palpation fixes the high standing of the bottom of the uterus and the friability of the organ.
2. Look at the chair. Neck - enlarged, inflamed. The cervical pharynx is open, there are blood clots in it. In addition, the uterine fundus will be located higher. Possible uterine bend.
3. Ultrasound examination. This method reveals the remaining placental tissues, clots in the lochia. Particularly relevant are the values ​​of the parameters of the uterus in length and width. Indeed, with subinvolution, there is no proper contraction of the organ.
4. Hysteroscopy. A radical method that is used in serious situations. Using an optical device, the uterine cavity is assessed from the inside, and an analysis of the contents of the organ is also taken.

The data presented in the table indicate a gradual decrease in all parameters of the reproductive organ. This occurs only with a healthy uterine involution.

Causes and treatment of uterine dysfunction

After diagnosing the disease, the gynecologist must find out the cause of its occurrence. After all, the chosen method of treatment depends on it.

The occurrence of subinvolution of the uterus is influenced by natural and infectious factors. Natural causes of weak uterine contractions include:

• stretching of the organ as a result of multiple pregnancy, polyhydramnios, large fetus;
• rapid or prolonged childbirth;
• myoma, adenomyosis;
• incision due to caesarean section;
• age pregnancy;
• lack of physical activity after childbirth.

The reasons described make it difficult for the normal contraction of the uterine muscles.

Infectious factors are:

• infection due to childbirth, curettage, abortion;
• inflammation caused by remnants of the amniotic membrane, placenta;
• concomitant diseases (pyelonephritis, venereal diseases).

After determining the cause that provoked the pathological process, the necessary therapy begins.

In the case of an infectious disease, antibacterial drugs are prescribed that effectively fight the focus of infection, eliminating inflammation.

To prevent subinvolution of the uterus, doctors still in the delivery room carry out various activities after childbirth aimed at uterine contraction:

• light external massage of the uterus;
• applying an ice pack to the lower abdomen;
• bladder catheterization and urinary diversion (a full bladder prevents normal uterine contraction);
• attachment of the newborn to the breast.

If particles of the fetal bladder, placental residues are found in the cavity, the vacuum cleaning method is used. With the help of this procedure, pathological contents are removed, pathogenic flora is eliminated.

Breastfeeding promotes healthy uterine muscle contraction. Since in the process of feeding, oxytocin is produced, which contributes to the speedy muscle contraction.

The true form of uterine subinvolution is corrected by medications that accelerate contractions of the organ. These funds also slow down bleeding, return the uterus to full activity.

Treatment of subinvolution of the uterus is carried out with the following medicines:

• oxytocin on the first day after birth;
• prostaglandins in the following days.

The drugs are administered intramuscularly most often.

In addition, uterine massage on the fist is sometimes used, but this method is used for hypotension with severe bleeding.

Subinvolution is easily treated if therapy is started in a timely manner. This will allow the woman to avoid complications such as bleeding.

An active lifestyle after childbirth is the main preventive method of dealing with uterine subinvolution. Young mothers should not lie in bed for a long time, because any physical activity activates blood circulation in all organs and tissues. Of no small importance is the performance of ultrasound after childbirth two weeks after discharge from the hospital.

Every woman who has given birth to a child is mentally and physically exhausted for the first month. Also, many are worried that subinvolution of the uterus does not occur. It is no coincidence that doctors consider exactly 10 months of pregnancy - this is already taking into account the involutionary period, from birth to the restoration of the female body after childbirth.

Subinvolution of the uterus: what is it?

Immediately after labor on the first day, a woman feels weakness and drowsiness. The next day she feels much better and the following days are quite normal: the condition is satisfactory, the woman is gaining strength. Sometimes there may be mild pain associated with muscle strain during childbirth, but they are quite tolerable.

But still, subinvolution of the uterus may occur in the postpartum period. You can not detect it immediately, but after about 7 days after birth.

This is a deviation that reduces the normal contraction of the uterus under the influence of complications. Therefore, the uterus cannot acquire its normal shape.

The period of postpartum activity is called the involution of the uterus. During which the woman in labor ends with the reverse development of systems and internal organs that have undergone certain changes during pregnancy and childbirth.

The postpartum large uterus has a weight of about one kilogram and a volume of about 5000 ml, and a non-pregnant 70 g, a volume of 5 ml. Immediately after childbirth, the bottom of the uterus is determined by palpation at an average distance of the womb and navel.

If the size reduction occurs instantly, this is the result of the expulsion of the fetus, amniotic fluid, and placenta. It also indicates that hormonal stimulation has been stopped.

Involution of the uterus involves a number of changes. After childbirth, the uterus actively contracts, then it acquires a spherical shape, slightly flattened.

After studying the process in the longitudinal section of the organ, on the third day, the uterus has a spherical shape, by the fifth - oval, on the seventh - pear-shaped. Such information can be obtained with the help of an external examination by a gynecologist or ultrasound.

The main task of the doctor after childbirth is the correct diagnostic assessment of changes in the uterus. It is necessary to exclude factors that can interfere with natural involution. Such measures play an important role in detecting infectious and inflammatory complications at an early stage.

The norm is the heterogeneous structure of the meometrium after childbirth, this is due to the anatomical features of the uterine blood flow, the vascular bed, tissue swelling and the volume of the intercellular fluid, changes in which occur throughout the entire involutionary period.

Possible causes and characteristic symptoms

In rare cases, the disease may appear for no apparent reason. Experts attribute this to poor heredity or the negative impact of the ecological situation in the metropolis.

Of course, there are predisposing factors that increase the chances of developing pathology.

Therefore, consider what you need to pay attention to in order to prevent subinvolution:

• Age. For example, in girls, the uterus may not yet develop sufficiently, but in adulthood in women, the contraction function begins to fade. Therefore, if you are at risk, pay attention to your body.
• Surgical intervention during childbirth. If an emergency caesarean is needed, internal organs may be damaged or tissues may be injured.
• Childbirth with complications. For example, if a large fetus, multiple pregnancy, or the child is far from the first in a row. The consequences are unpredictable.
• Congenital pathologies of the uterus. In such a situation, everything will become known even before pregnancy or on time, it may be necessary to take early measures.
• Gynecological diseases. Of course, the close monitoring of doctors and all kinds of maintenance of pregnancy is possible, but the percentage of postpartum abnormalities is high.
• Weakened immunity. Infections and anemia adversely affect the condition of the uterus, so the consequences will make themselves felt.
• Excessive, unhealthy loads during the gestation period. It is important during this period to take care of yourself and follow the recommendations of the doctor.
• Aware means armed. Therefore, if a woman is at risk, constant medical supervision is recommended. Risks are assessed taking into account the state of the body, genetics, the nature of the pathology and other factors.

The first thing that should be a cause for alarm is the discharge, which is homogeneous in nature, brown in color, similar to abundant blood discharge from the uterus.

Important! If the obstetrician-gynecologist did not pay attention or overlooked, be sure to point out to him such a symptom.

During the examination, the gynecologist may be excited by a large, loose uterus. In some cases, deviations may be indicated by an elevated temperature of about 37-37.5, which does not decrease for a long period of time.

Another symptom that requires attention is the absence of characteristic cramping pains in the lower abdomen, including during direct breastfeeding.

Such a symptom indicates that an inflammatory process begins in the body, so if at the time of such signs you are already at home, and not in the hospital, seek medical help immediately.

It is also important to note that postpartum subinvolution of the uterus occurs without characteristic pain, so the woman does not feel anything and can not guess about the problem.

Diagnostics

If subinvolution is suspected, the gynecologist sends for an ultrasound examination. Ultrasound can not only confirm or refute the diagnosis, but also establish a possible cause that prevents the uterus from contracting normally.

Sonography can also be performed: it helps to determine the presence or absence of pathological inclusions in the uterine cavity. Such a procedure is necessary in order to choose the right treatment tactics.

How is the treatment?

The course of treatment directly depends on the manifestation of clinical symptoms and the type of pathology. If subinvolution is accompanied by inflammation, this means that the disease is independent, therefore, antibacterial drugs are needed.

In the presence of an infection, in addition to antibiotic therapy, agents are prescribed that improve blood flow and thin the blood in the uterus. The duration of treatment is about 10 days.

To treat the true type of disease, drugs are prescribed that stimulate muscle tone. If there is no intoxication, then clots in the uterus can be removed using a vacuum pump.

A saline solution is used to completely wash out the lochia. Topical treatment with ovarian and uterine massage treatments is also possible. If there is a virus, then injections of drugs are administered intramuscularly: Colostrum, Oxytocin, Ergot. Autohemo - and novocaine therapy is quite effective.

Intrauterine injection: "Exuter", "Neofur", "Metromax", intravenous solution of ascorbic acid with glucose.

The following complications are also possible:

• lochia stagnation;
• infection;
• endometritis.

Preventive measures

Every woman should understand that in order to reduce the risk of complications, it is necessary to take preventive measures before pregnancy.

The first thing to do is to undergo all medical and clinical examinations, eliminate problems (if any) and consult with the necessary specialists.

Most likely, it will not hurt to perform Kegel therapeutic exercises in order to increase muscle tone. This is necessary to increase firmness and elasticity, so that after childbirth the muscles return to their previous shape without complications - this is important for the period of involution.

It is necessary to remember about the observance of the rules of intimate hygiene during pregnancy and follow the doctor's recommendations. Also, after two weeks after childbirth, it is important to visit a gynecologist so that he can detect deviations in a timely manner and prescribe appropriate treatment.

The female body after delivery begins to restore its previous functions, including returning the uterus to its original size. However, this process may not be as active as it should be. In this case, subinvolution of the uterus is diagnosed. Experts distinguish two groups of causes that provoke insufficiency of uterine contractility, on which the treatment method depends. This pathological condition must necessarily be cured, since it poses a risk of infertility.

What is subinvolution?

Subinvolution of the uterus is a term for incomplete or partial recovery of the uterus after childbirth. After delivery, the uterus begins to contract intensively. This process usually lasts for 1.5-2 months, but in some cases, violations may occur. Due to various reasons, the uterus is able to take an unnatural shape, and due to the weakness of the ligaments that support it, an inflection may even occur.

As a rule, the first signs of incorrect involution are noted a week after the birth of the child. But doctors with extensive practical experience can detect insufficient contraction intensity already 2-3 days after delivery. For this reason, the woman in labor is additionally examined before being discharged from the maternity hospital.

Subinvolution of the uterus a week after birth can be determined by the excess weight of the organ. For example, by this time, a mass of 500-600 g is considered normal, after 2 weeks - 350 g, and after a month - 120 g.

The reasons

Insufficiency in uterine contraction is caused by various reasons. They are all divided into two main groups:

1. Natural. The following factors can provoke subinvolution of the uterus:
   • high water;
   • multiple pregnancy or large fetus;
   • uterine fibroids;
   • adenomyosis;
   • scar from caesarean section;
   • consequences of an abortion;
   • prolonged or too fast labor, which can cause overstrain or muscle strain.
2. 2. Infectious. Infection of the uterine cavity can occur during childbirth, during curettage, or sexually. Particles of the placenta or amniotic membrane, concomitant chronic diseases, such as anemia or pyelonephritis, are capable of provoking inflammation.

Due to insufficient muscle contractility, postpartum endometritis can develop or infectious diseases can join.

Symptoms

Independently, a woman after childbirth can recognize the subinvolution of the uterus by the following clinical signs:

• profuse, prolonged bleeding from the vagina with an unusual dark color and an unpleasant odor;
• an increase in body temperature to 37-37.5 degrees (in the presence of inflammatory processes in the uterus).

If these symptoms occur, a woman needs to seek medical help, even if pain is not observed (pain appears only with inflammation of the tissues). Doctors should check the condition of the uterus. With subinvolution, they can detect a loose inner surface and increased organ size.

If there is a suspicion of insufficient contractility of the uterus, the doctor prescribes an ultrasound scan. It allows you to confirm a possible diagnosis, including establishing the cause of subinvolution.

Treatment

The most favorable treatment option will be upon detection of insufficiency in the contractility of the muscles of the uterus during the first day after childbirth. This allows you to take appropriate measures to prevent complications.

Treatment options vary depending on the type of uterine subinvolution. Therefore, when a disease is detected at home, you need to get an appointment from a doctor.

Infectious subinvolution

When diagnosing subinvolution of the uterus of an infectious type, therapy is directed to the destruction of bacteria - the source of infections. The patient is prescribed antibiotic therapy, which allows you to eliminate the cause and foci of inflammation.

During the period of breastfeeding, antibacterial drugs should be used with caution, because their choice should be dealt with by a doctor. Women should not independently change the dosage or treatment regimen. It is worth remembering that insufficient therapy can provoke the transition of the infection into a chronic form.

Medicines are prescribed that reduce the density of blood and normalize blood circulation in the uterus. Usually, infectious subinvolution is treated with medications for 8-10 days.

If the inflammatory process in the uterus and its insufficient contraction were provoked by the remnants of the placenta or fetal membranes, then a procedure is performed to remove them. To do this, doctors resort to the use of a vacuum pump, which allows you to clean the birth canal.

Rinse with brine. According to a special technology, douching of the birth canal is performed to wash out the remnants of lochia (postpartum discharge).

True subinvolution

In this case, treatment is carried out in several stages. The doctor chooses a specific technique depending on the causes of the pathological condition.

To reduce the uterus to natural size can be applied:

• medicines;
• phytotherapy;
• physiotherapy.

Preparations for contracting the walls of the uterus

To speed up the process of uterine contraction and achieve its previous size, special medicines can be used. The most popular is the drug Oxytocin. It contains a hormone from the posterior pituitary gland, which is injected intramuscularly into the uterus. It helps to slow down bleeding and restore the contractility of the organ.

In addition to Oxytocin, ergot-based drugs are used. They are used only in extreme cases, since they can worsen lactation.

To restore the contractile activity of the uterus, doctors can use a special massage. Stimulation of normal involution is achieved by influencing active points.

Phytotherapy

Traditional medicine methods are recommended to be used only as additional measures. In no case should you resort to self-medication without the permission of the attending physician. Incorrect selection of herbal remedies can aggravate the course of the disease.

To restore the contractile activity of the uterus, decoctions and infusions from the following plants can be used:

• nettle;
• birch leaves;
• yarrow;
• horsetail;
• shepherd's bag;
• tricolor violet.

It is advisable to purchase raw materials in pharmacies, since the effectiveness and safety of treatment is highly dependent on the quality and purity of the product. The scheme and method of their use should be clarified with a doctor.

It is worth noting that the use of herbal teas and infusions can lead to a deterioration in the taste of breast milk, because of which the child will begin to eat poorly. It is much more dangerous if the active ingredients of herbal medicine provoke an allergic reaction in a newborn. Therefore, to a greater extent, decoctions are recommended for douching.

Physiotherapy

A woman after childbirth needs to lead an active lifestyle. It is impossible for her to stay in a lying position for a long time (unless the attending physician requires it). She has to move a lot. Moderate physical activity contributes to the normalization of blood circulation in the pelvic organs and tones the uterus.

The Kegel method is a very popular technique aimed at strengthening the muscles of the pelvic floor and abdominal cavity. Its essence lies in the alternate contraction and relaxation of muscles. To understand which ones you need to train, it is advised to try to interrupt the act of urination. Having identified and learned to control the muscle group involved in the process of excreting urine, you can start the exercise at any time.

1. 1. "Delay". You need to lie on your back, bend your legs at the knees and slightly spread them to the sides, hands are placed along the body - the starting position. They strain the muscles, simulating the stop of urination, linger in this state for 10 seconds, after which they relax the muscles and rest. It is necessary to perform up to 8 repetitions, gradually increasing this number to 30.
2. 2. "Wave". The starting position is the same. The essence of the exercise is to alternately tighten the sphincter muscles of the anus and vagina, and it is desirable to achieve relaxation in the reverse order.
3. 3. "Elevator". The same starting position is taken. When performing the exercise, you need to achieve a gradual tension of the vagina, starting with the tubular muscles located below. At each stage, you need to stop for a few seconds. Relaxation should be done in the same order. It is recommended to perform up to 20-30 repetitions.

The postpartum period for a woman is not always smooth. In some cases, complications are possible, among which subinvolution of the uterus stands out.

What is subinvolution of the uterus after childbirth and the reasons for its formation

Subinvolution of the female reproductive organ - a delay in its recovery to natural (prenatal) sizes. Pathology is usually observed a week after delivery.

The frequency of subinvolution of the uterus after caesarean section is 11-13%, and after childbirth through the birth canal reaches 30-50%; carrying out complex therapy for prophylactic purposes reduces these indicators by 50-60%.

ON THE. Morozova, Candidate of Medical Sciences, Associate Professor of the Department of Obstetrics, Gynecology and Perinatology, FIPO DonNMU named after. Gorky

http://www.mif-ua.com/archive/article/10691

It is no coincidence that doctors call the first three months after the birth of a baby the fourth trimester of pregnancy. The fact is that during this period the body returns to the prenatal state: the hormonal background normalizes, the organs take on their natural state. This process is called involution. However, in some cases it slows down. In this case, the cervix is ​​blocked by the remnants of the placenta and the fetal membrane, blood clots.

After childbirth, the female reproductive organ looks like an open wound. In the first three days, the upper layer of the uterine mucosa dies and leaves the cavity. If this process is delayed, an infection joins the dead tissue, which contributes to the development of endometritis.

An important factor in postpartum subinvolution is the decrease in the protective functions of the mother's body, which can lead to infection of the uterine mucosa.

The main causes of subinvolution are called:

• infections - inflammation can be triggered against the background of diseases such as pyelonephritis, anemia. In addition, infection is possible during labor, caesarean section, due to retention of placental remnants, fetal egg;
• Mechanical impact - excessive stretching of the uterus, which is caused by multiple or polyhydramnios pregnancy, rapid or prolonged labor, a large fetus, as well as a sedentary image after delivery.

Later restoration of the organ can occur with myoma (benign tumor) of the uterus, late (after 40 years) or, conversely, early childbirth (up to 18 years). Doctors say that the lack of breastfeeding for 4-5 days increases the likelihood of complications. The fact is that when the baby is attached to the breast, the hormone oxytocin is produced, the uterus begins to contract and decrease in size.

Symptoms of the disease

The main symptom is bloody discharge of a dark color with an unpleasant odor. Often bleeding is observed in the late postpartum period (at 3-4 weeks).

In obstetric practice, the daily lowering of the uterus by 1-2 cm is considered the norm, and after 2 weeks it should completely take its natural position.

Doctors call other signs of subinvolution:

• an increase in body temperature - occurs against the background of an infection. The temperature can be either subfebrile (37 0 C - 37.5 0 C) or high (up to 39 0 C);
• there are no cramping pains during breastfeeding;
• pulling pain in the lower abdomen, which are not associated with applying the baby to the chest;
• discoloration of discharge from bloody to purulent.

In what cases it is necessary to see a doctor

If any unpleasant symptoms appear, a woman should immediately contact a gynecologist.

During the examination, the doctor may observe an enlarged uterus, which has a loose surface. On palpation, the woman feels pain. To clarify the diagnosis, an ultrasound examination is prescribed. The method allows to identify the presence of pathological inclusions, the nature of the complication, the size of the uterus.

If there is a suspicion of a delay in the recovery of the uterus after childbirth, an ultrasound examination is performed, as well as hysteroscopy and MRI

If necessary, appoint:

• MRI - allows you to examine the uterus from all sides at once, examine the walls of the organ and the endometrial layer;
• hysteroscopy - makes it possible to study the pathology of the inner layer of the uterus.

Treatment of blood clots in the uterus

If the diagnosis is confirmed, the woman is prescribed treatment depending on the form of the complication.

Antibacterial therapy

When establishing an infectious manifestation of a complication, antibacterial drugs are used.

It should be borne in mind that when feeding a baby, the list of medicines that can be used by a nursing woman is significantly reduced.

Usually, the doctor prescribes drugs from the group of semi-synthetic penicillins with an extended spectrum of action. In some cases, drugs of the cephalosporin group with metronidazole may be prescribed. It must be remembered that when using these drugs, breastfeeding is stopped for a while.

In the presence of a viral infection, the doctor may prescribe intramuscular infections with sinestrol, ergot, oxytocin drugs. In case of severe intoxication, colloidal blood substitutes (sodium chloride, magnesium chloride, calcium chloride) are used.

Drugs for the treatment of subinvolution - table

Medications for uterine contraction after childbirth - gallery

Analgin-Quinine helps to reduce pain, promotes contraction of the uterus after childbirth or abortion Ergometrine is one of the main ergot alkaloids, which indicates a direct effect on the uterus and causes its persistent contraction Oxytocin is prescribed to contract the uterus to prevent postpartum hemorrhage.

Therapy with antibacterial drugs is carried out only according to the doctor's prescription in a strictly specified dosage.

If the pathology is caused by the initial signs of endometritis (inflammation of the inner layer of the uterus), the woman is prescribed blood-thinning drugs and drugs that improve blood circulation.

During the treatment, an ultrasound examination is performed on every third and last day.

Vacuum application

If the remains of the placenta, the fetal membrane are found in the uterine cavity, then against the background of antibiotic therapy, vacuum aspiration is performed using a vacuum pump and subsequent washing of the uterus with therapeutic solutions.

During the procedure, the external genitalia are treated with antiseptic preparations. A special tube is inserted into the uterine cavity, which is connected with a syringe or an electric aspirator. The specialist, rotating the catheter, clears the cavity of blood clots.

Vacuum aspiration is performed after childbirth to remove blood clots and other accumulations without damaging the neck of the organ and its walls

After vacuum aspiration, it is necessary to visit a gynecologist after two weeks.

If subinvolution is caused by mechanical action, the doctor may prescribe physiotherapy:

• magnetotherapy - with the help of a special apparatus, magnetic fields are exposed to certain parts of the body;
• electrical stimulation - the impact on the body of current pulses in order to restore weakened organs or systems.

Usually, recovery occurs on the 7-10th day, depending on the complexity of the complication and the individual characteristics of the woman's body.

Phytopreparations

In addition to the main method of treatment, the use of herbal teas is allowed. It should be borne in mind that the use of medicinal herbs is only an auxiliary method. It is strictly forbidden to take herbal remedies on your own, as this can cause negative manifestations and lead to a worsening of the course of the disease.

The following medicinal plants are most widely used:

• nettle;
• yarrow;
• horsetail;
• shepherd's bag.

Medicinal plants for the treatment of subinvolution - gallery

Nettle has a beneficial effect on the hormonal background, has a hemostatic effect Yarrow has an analgesic, hemostatic effect Horsetail is taken as a hemostatic, wound healing, anti-inflammatory agent Shepherd's purse is recommended for menstrual irregularities, and also after childbirth, if heavy bleeding is observed

An infusion is prepared from dry raw materials as follows: 4 tbsp. l. herbs are poured into 0.5 liters of boiling water and infused for 15-20 minutes. Take 100 ml 3 rubles / day for two weeks.

Self-medication is strictly prohibited. The use of medicinal herbs is possible only after consultation with your doctor.

Often, expectant mothers are scared of all sorts of complications after childbirth - doctors, parents, more experienced girlfriends. Yes, the recovery process does not always go smoothly, and one of the side effects of childbirth can be subinvolution of the uterus. In order not to panic when a doctor announces an unfamiliar diagnosis, we suggest that you familiarize yourself with this phenomenon in theory.

What is uterine subinvolution

First of all, it should be noted that it is no coincidence that doctors called the first month after childbirth the tenth month of pregnancy. During this period, reverse processes occur in the woman's body - pregnancy hormones disappear, organ functions are restored. In general, this is called involution, which means reverse development. Under favorable circumstances, this period takes three months after delivery.

However, a new mother may begin subinvolution of the uterus after childbirth. Often it can be diagnosed a week after delivery. In the presence of this disease, the cervix can be blocked by particles of membranes, placental remnants and blood clots. Also, the uterus may bend due to weakened ligaments.

The exact definition of the disease is as follows: slowing down the process of reverse development of the uterus, due to viral or mechanical damage. Simply put, with subinvolution, the uterus cannot contract to its natural size.

Symptoms of the disease

The first alarming sign of subinvolution is considered to be incessant heavy bleeding unusual brown. If the obstetrician overlooked, your task is to trace and point out to him this symptom. On examination, the gynecologist may alert enlarged loose uterus .

Sometimes a little can indicate a disease fever body - within 37-37.5 about - for a long period of time. It signals a sluggish inflammatory process in the body. If by the time these symptoms appear you have already been discharged from the hospital, do not delay going to the doctor.

Why does subinvolution occur?

There are two types of subinvolution of the uterus after childbirth - infectious nature and the so-called true . The first is caused by inflammatory processes after childbirth, against the background of diseases such as pyelonephritis and anemia in pregnant women. Also, the infection can be introduced during childbirth, or the inflammation occurs due to the retention of the remnants of the placenta and membranes in the uterine cavity.

True subinvolution is considered an ailment caused by mechanical excessive stretching of the uterus due to polyhydramnios during pregnancy, if you carried a large baby or twins, with rapid or prolonged delivery. Also, this form of subinvolution sometimes occurs after a caesarean section, and against the background of diseases such as cervical fibroids or adenomyosis.

For an accurate diagnosis of subinvolution of the uterus, the doctor must prescribe an ultrasound examination.

Treatment of subinvolution

Treatment of this disease depends on the form of its clinical course. If the subinvolution of the uterus after childbirth is accompanied by an inflammatory process, then it is an independent disease and requires treatment. antibiotics . Postpartum subinvolution can only be the initial stage of such a disease as endometritis.

If a doctor has found an infection in a woman's body, then most likely antibacterial drugs and drugs that thin the blood and improve blood circulation in the uterus will be prescribed. Usually recovery is a matter of 7-10 days, but, of course, it all depends on the woman's immunity.

With true subinvolution, which in itself is only a symptom of uterine distension, medications are prescribed that stimulate muscle tone . This allows the tissues to regain density and bounce back faster.

In the absence of intoxication in the body, blood clots are removed from the uterine cavity with a special vacuum pump . Also, lochia - postpartum discharge - can be washed out of the vagina with cold saline. In addition to general treatment, a local one can be prescribed - a local effect on the problem by rectal massage uterus and ovaries.

In the presence of a virus most likely, the method of intramuscular injection of ergot, oxytocin, sinestrol or colostrum preparations will be used. One of the most effective therapies for subinvolution of the uterus is novocaine and autohemotherapy.

Preparations neofur, hysteroton, metromax, exuter or furazolidone sticks are administered intrauterine. A solution of glucose with ascorbic acid - intravenously.

To reduce the side effects of antibiotic treatment, refer to herbal medicine . Herbal preparations give a noticeable result and do not harm health.

The following recipe is extremely useful:

two parts of lagohilus herb and arnica flowers, mixed with one part of yarrow herb. Pour a tablespoon of the mixture with 250 ml of boiling water, close tightly and let it brew for half an hour. Strain the resulting infusion. Take 50 ml before meals twice a day. The minimum course is 14 days, the maximum is a month.

If you have had a complicated delivery, in order to prevent the doctor can prescribe herbal teas from nettle, yarrow, shepherd's purse, horsetail, birch leaves, tricolor violet. To enhance the effect, you can do vaginal douching based on the listed plants.

In this article:

For every woman who has given birth to a long-awaited baby, the first month is the most important moment, both psychologically and physically, so that subinvolution does not occur (more on that below). It is no coincidence that many doctors consider it the 10th month of pregnancy. During this time, the female body restores its strength, after heavy loads during childbirth. This period is called involution, begins after the birth of a child and can last for about three months.

On the very first day after the appearance of the baby, the woman still feels very tired and sleepy. The next day and subsequent days are normal and the woman's condition is satisfactory. In some cases, pain associated with muscle strain may occur, but, as a rule, they are tolerable.

However, in some cases, uterine subinvolution may occur after delivery. In most cases, it is detected 7 days after birth. This pathology is a reduced contraction of the uterus due to any complication. As a result, she cannot take her natural size. In this case, the kinks of the uterus due to weak ligaments are not excluded.

Causes

There are two types of causes of subinvolution of the uterus: infectious and natural. In the first case, the appearance is due to inflammatory processes along with pyelonephritis and anemia of a pregnant woman. In addition, the infection can be introduced during childbirth, or inflammation can occur from the remnants of the placenta, fetal membranes in the uterus.

Natural pathology can occur with a strong stretching of the uterus due to polyhydramnios, when carrying a large child or twins. This also includes cases after a caesarean section and in the presence of cervical fibroids or adenomyosis.

Symptoms of manifestation

The main symptom, according to which subinvolution of the uterus can be observed after childbirth, is heavy bleeding, which does not stop and has an unusual brown color. When visiting a gynecologist, a loose and enlarged uterus should alert the doctor. In some cases, the presence of this pathology can signal a temperature of 37 or 37.50C, which lasts a very long time. This suggests that inflammatory processes are taking place in the body. And if the woman has already been discharged by this time, then the trip to the doctor should not be postponed.
It is worth noting that the subinvolution of the uterus after childbirth proceeds without pain and the woman does not feel anything.
Treatment

To establish an accurate diagnosis of subinvolution of the uterus after childbirth, the doctor prescribes an ultrasound examination. If this pathology is detected, appropriate treatment is prescribed, which depends on the severity. If a postpartum complication occurs in the presence of an inflammatory process, then antibiotics are used to treat it.

In addition, such a pathology may be the initial sign of endometritis. In this case, the treatment is carried out with antibacterial drugs and drugs that thin the blood, thereby improving the blood circulation of the uterus. As a rule, recovery occurs after 7-10 days of treatment and in most cases it all depends on the individual characteristics of the body of each woman. In the rarest cases, treatment may take longer than the specified period.

If the subinvolution of the uterus after childbirth proceeds in a natural form, due to a large stretching of the muscles of the uterus, then in this case the radiation doctor prescribes drugs that tone them up. Usually it is methylergometrine or oxytocin. Tissues restore their density and return to normal faster.

In the absence of poisons in the woman's body, the removal of blood clots is carried out using a special vacuum pump. In addition, postpartum discharge is washed out with a cold saline solution. Also, a rectal massage of the uterus and ovaries shows a good result.

In some cases, in the presence of the virus, drugs such as ergot, oxytocin, sinestrol, or colostrum are prescribed, which are injected intramuscularly. In addition, treatment can be carried out using other effective means: novocaine and autohemotherapy.

In the treatment of subinvolution of the uterus after childbirth with drugs: neofur, hysteroton, metromax, exuter, furazolidone sticks, they are administered intrauterine. Glucose with ascorbic acid is administered intravenously.

Prevention

In order to reduce the side effects of antibiotics, it is recommended to carry out herbal medicine. The use of various herbal preparations gives an excellent result, but most importantly, it does not have a harmful effect on the body. Herbal teas from such useful herbs as nettle, yarrow, shepherd's purse, horsetail, birch leaves, tricolor violet are considered good prophylactic agents after the subinvolution of the uterus after childbirth.

Each method of treatment gives good results and recovery. However, the best remedy is the prevention of the disease itself. To do this, every pregnant woman needs to properly prepare for the upcoming birth. There is a set of Kegel exercises that allow you to restore the normal size of the uterus from a stretched state. The use of these exercises even when planning pregnancy will avoid the occurrence of postpartum complications.

The postpartum period for a woman is not always smooth. In some cases, complications are possible, among which subinvolution of the uterus stands out.

What is subinvolution of the uterus after childbirth and the reasons for its formation

Subinvolution of the female reproductive organ - a delay in its recovery to natural (prenatal) sizes. Pathology is usually observed a week after delivery.

The frequency of subinvolution of the uterus after caesarean section is 11-13%, and after childbirth through the birth canal reaches 30-50%; carrying out complex therapy for prophylactic purposes reduces these indicators by 50-60%.

ON THE. Morozova, Candidate of Medical Sciences, Associate Professor of the Department of Obstetrics, Gynecology and Perinatology, FIPO DonNMU named after. Gorky

http://www.mif-ua.com/archive/article/10691

It is no coincidence that doctors call the first three months after the birth of a baby the fourth trimester of pregnancy. The fact is that during this period the body returns to the prenatal state: the hormonal background normalizes, the organs take on their natural state. This process is called involution. However, in some cases it slows down. In this case, the cervix is ​​blocked by the remnants of the placenta and the fetal membrane, blood clots.

After childbirth, the female reproductive organ looks like an open wound. In the first three days, the upper layer of the uterine mucosa dies and leaves the cavity. If this process is delayed, an infection joins the dead tissue, which contributes to the development of endometritis.

An important factor in postpartum subinvolution is the decrease in the protective functions of the mother's body, which can lead to infection of the uterine mucosa.

The main causes of subinvolution are called:

• infections - inflammation can be triggered against the background of diseases such as pyelonephritis, anemia. In addition, infection is possible during labor, caesarean section, due to retention of placental remnants, fetal egg;
• Mechanical impact - excessive stretching of the uterus, which is caused by multiple or polyhydramnios pregnancy, rapid or prolonged labor, a large fetus, as well as a sedentary image after delivery.

Later restoration of the organ can occur with myoma (benign tumor) of the uterus, late (after 40 years) or, conversely, early childbirth (up to 18 years). Doctors say that the lack of breastfeeding for 4-5 days increases the likelihood of complications. The fact is that when the baby is attached to the breast, the hormone oxytocin is produced, the uterus begins to contract and decrease in size.

Symptoms of the disease

The main symptom is bloody discharge of a dark color with an unpleasant odor. Often bleeding is observed in the late postpartum period (at 3-4 weeks).

In obstetric practice, the daily lowering of the uterus by 1-2 cm is considered the norm, and after 2 weeks it should completely take its natural position.

Doctors call other signs of subinvolution:

• an increase in body temperature - occurs against the background of an infection. The temperature can be either subfebrile (37 0 C - 37.5 0 C) or high (up to 39 0 C);
• there are no cramping pains during breastfeeding;
• pulling pain in the lower abdomen, which are not associated with applying the baby to the chest;
• discoloration of discharge from bloody to purulent.

In what cases it is necessary to see a doctor

If any unpleasant symptoms appear, a woman should immediately contact a gynecologist.

During the examination, the doctor may observe an enlarged uterus, which has a loose surface. On palpation, the woman feels pain. To clarify the diagnosis, an ultrasound examination is prescribed. The method allows to identify the presence of pathological inclusions, the nature of the complication, the size of the uterus.
If there is a suspicion of a delay in the recovery of the uterus after childbirth, an ultrasound examination is performed, as well as hysteroscopy and MRI

If necessary, appoint:

• MRI - allows you to examine the uterus from all sides at once, examine the walls of the organ and the endometrial layer;
• hysteroscopy - makes it possible to study the pathology of the inner layer of the uterus.

Treatment of blood clots in the uterus

If the diagnosis is confirmed, the woman is prescribed treatment depending on the form of the complication.

Antibacterial therapy

When establishing an infectious manifestation of a complication, antibacterial drugs are used.

It should be borne in mind that when feeding a baby, the list of medicines that can be used by a nursing woman is significantly reduced.

Usually, the doctor prescribes drugs from the group of semi-synthetic penicillins with an extended spectrum of action. In some cases, drugs of the cephalosporin group with metronidazole may be prescribed. It must be remembered that when using these drugs, breastfeeding is stopped for a while.

In the presence of a viral infection, the doctor may prescribe intramuscular infections with sinestrol, ergot, oxytocin drugs. In case of severe intoxication, colloidal blood substitutes (sodium chloride, magnesium chloride, calcium chloride) are used.

Drugs for the treatment of subinvolution - table

Medications for uterine contraction after childbirth - gallery

Analgin-Quinine helps to reduce pain, promotes contraction of the uterus after childbirth or abortion Ergometrine is one of the main ergot alkaloids, which indicates a direct effect on the uterus and causes its persistent contraction Oxytocin is prescribed to contract the uterus to prevent postpartum hemorrhage.

Therapy with antibacterial drugs is carried out only according to the doctor's prescription in a strictly specified dosage.

If the pathology is caused by the initial signs of endometritis (inflammation of the inner layer of the uterus), the woman is prescribed blood-thinning drugs and drugs that improve blood circulation.

During the treatment, an ultrasound examination is performed on every third and last day.

Vacuum application

If the remains of the placenta, the fetal membrane are found in the uterine cavity, then against the background of antibiotic therapy, vacuum aspiration is performed using a vacuum pump and subsequent washing of the uterus with therapeutic solutions.

During the procedure, the external genitalia are treated with antiseptic preparations. A special tube is inserted into the uterine cavity, which is connected with a syringe or an electric aspirator. The specialist, rotating the catheter, clears the cavity of blood clots.
Vacuum aspiration is performed after childbirth to remove blood clots and other accumulations without damaging the neck of the organ and its walls

After vacuum aspiration, it is necessary to visit a gynecologist after two weeks.

If subinvolution is caused by mechanical action, the doctor may prescribe physiotherapy:

• magnetotherapy - with the help of a special apparatus, magnetic fields are exposed to certain parts of the body;
• electrical stimulation - the impact on the body of current pulses in order to restore weakened organs or systems.

Usually, recovery occurs on the 7-10th day, depending on the complexity of the complication and the individual characteristics of the woman's body.

Phytopreparations

In addition to the main method of treatment, the use of herbal teas is allowed. It should be borne in mind that the use of medicinal herbs is only an auxiliary method. It is strictly forbidden to take herbal remedies on your own, as this can cause negative manifestations and lead to a worsening of the course of the disease.

The following medicinal plants are most widely used:

• nettle;
• yarrow;
• horsetail;
• shepherd's bag.

Medicinal plants for the treatment of subinvolution - gallery

Nettle has a beneficial effect on the hormonal background, has a hemostatic effect Yarrow has an analgesic, hemostatic effect Horsetail is taken as a hemostatic, wound healing, anti-inflammatory agent Shepherd's purse is recommended for menstrual irregularities, and also after childbirth, if heavy bleeding is observed

An infusion is prepared from dry raw materials as follows: 4 tbsp. l. herbs are poured into 0.5 liters of boiling water and infused for 15-20 minutes. Take 100 ml 3 rubles / day for two weeks.

Self-medication is strictly prohibited. The use of medicinal herbs is possible only after consultation with your doctor.

The postpartum period is a complex recovery process, the whole body must return to its previous state. But it doesn't always go smoothly and quickly. The subinvolution of the uterus after childbirth manifests itself precisely at this stage of the regeneration of the reproductive system and internal organs. You should not immediately panic when you hear the diagnosis, you need to carefully understand the nuances.

General information

Subinvolution of the uterus after childbirth is a slow process of reverse development of the organ for mechanical or viral reasons. After the expulsion of the fetus and afterbirth, the uterine muscles begin to contract intensively and push out the lochia (blood discharge). This has been happening for 2 months.

The uterus takes on an irregular shape after a pregnancy due to stretching of the supporting ligaments. Due to the peculiarities of the development of the reproductive organ in a woman, an inflection occurs.

Subinvolution is diagnosed within a week after delivery. When a pathology occurs, remnants of the placenta and other traces of pregnancy appear in the cervix: membranes, blood clots. The organ remains abnormally large.

There are 2 types of subinvolution:

1. infectious;
2. true.

The first type of pathology (infectious) is provoked by the appearance of inflammatory processes in the genital organs during the recovery period. Basically, problems develop due to certain diseases, such as pyelonephritis, blood diseases, anemia. Also, the infection can be introduced during childbirth. The cause of the manifestation of the anomaly is the remains of the placenta or fetal membranes, which remain in the middle of the uterus for a long time.

True subinvolution occurs after overstretching of the muscles of the reproductive organ due to polyhydramnios, when carrying a large fetus (or 2-3 fetuses at once). This type of involution pathology appears as a result of too rapid delivery or during caesarean section. Another impetus for manifestation is fibroids or adenomyosis.

To absolutely accurately identify the problem, the obstetrician prescribes an examination, including a complete diagnosis of the body. The patient will need to undergo an ultrasound of the reproductive system.

The reasons

Since the subinvolution of the uterus after childbirth is natural and infectious, the reasons for the manifestation are divided into two categories. Each affects the sexual organ from different sides.

Natural causes:

• excessive volume of amniotic fluid;
• multiple pregnancy, large child;
• the presence of fibroids;
• scars after surgical interventions on the uterine cavity;
• frequent abortions;
• prolonged or rapid labor.

There are also those factors that provoke the occurrence of anomalies of the recovery period with the help of infections. The pathogen enters the body during delivery, abortion or intimate relationships. If a woman does not get up for a long time, lochia with particles of the placenta do not come out and become inflamed inside. As a result, subinvolution occurs. Contribute to the development of chronic diseases of the kidneys and blood.

If the pathology appeared due to inflammatory processes in the reproductive system, on the 5th day the deviation flows into an independent disease that requires medication. In the absence of a full-fledged treatment, the disease will turn into endometritis, which is difficult to get rid of. With natural subinvolution, the tone of the uterine muscles is affected for rapid contraction.

Symptoms

The woman in labor will not be able to recognize the incorrect reverse development of the penis. However, there are certain markers of the presence of the disease.

Signs of the pathology of involution:

1. persistent profuse bleeding of a dark color with an unpleasant odor;
2. enlarged loose uterus after childbirth (detected only when examined by a gynecologist);
3. hyperthermia up to 37.5 degrees for a long time.

You can't do without an obstetrician-gynecologist. The increase in temperature is not given the necessary attention, and not all women in labor know the rate of postpartum lochia. During the establishment of breastfeeding, the body temperature rises to 37 degrees.

Bloody discharge is excessively abundant in the first week after the birth process. If such symptoms were identified upon discharge from the hospital, it is better to play it safe and go for a consultation with an obstetrician.

When, during an internal examination, the surface of the penis is too soft, this indicates the presence of an anomaly. The cause of a loose uterus is the abnormal reverse development of the uterus. Timely treatment will help to get rid of the pathology quickly and without consequences.

Diagnostics

The subinvolution of the uterus after labor is determined by comparing the true size and volume of the reproductive organ with the standards for a particular day of the postpartum period.

The anomaly is diagnosed by the following methods:

• using gynecological mirrors;
• ultrasound examination;
• echography.

The most common diagnostic method is ultrasound control. With it, it is easy to determine the size of the uterus and its weight. This will allow you to start treatment on time and quickly get rid of the problem.

Sonography is rarely used as a diagnostic method, mainly the method is used to determine the correct tactics of therapy. Any examination option is accompanied by the delivery of tests and smears on the microflora of the vagina.

Violation of involution is provoked not only by childbirth. The anomaly manifests itself even with a mechanical abortion or cleaning of the mucous membrane. Most often, subinvolution of the uterus appears after operations during delivery (caesarean section), during gestation (B-lynch suturing), or as a result of numerous abortions.

Women at risk should undergo an ultrasound before discharge from the hospital or within a week of the abortion. With subinvolution of the uterus after curettage, undergo an ultrasound examination after 1-1.5 weeks during the rehabilitation period.

Complications with improper reverse development of the penis:

1. infertility;
2. endometritis;
3. endometriosis;
4. uterine fibroids;
5. proliferation of the endometrium;
6. sepsis.

Subinvolution after abortion and childbirth does not happen very often, but there is still a risk of manifestation of the disease. Regular visits to the doctor are required in the postpartum period, as well as during medical termination of pregnancy by mechanical cleaning.

Infectious type treatment

For therapy to be effective, it is necessary to identify the disease as early as possible. It is best if the pathology is determined on the first day of the postpartum period. Treatment of subinvolution of the uterus after childbirth is prescribed depending on the type of anomaly. If the problem was not noticed before discharge from the hospital, you need to contact the obstetrician after the first signs of danger.

infectious type. In this case, therapy is directed to the neutralization of bacteria. Prescribed antibiotic drugs that affect the cause of the inflammatory process.

It is necessary to take a responsible approach to the choice of medicine, because most women breastfeed during this period. The patient during lactation must strictly adhere to the medication regimen so as not to harm the baby.

With an insufficient amount of antibiotic in the body, the disease goes into a chronic stage. The course of treatment is about two weeks. Along with antibiotic therapy, blood-thinning medications are taken. The action of drugs is aimed at normalizing the blood circulation of the uterus.

If the cause of the pathology is the remains of the placenta and membranes, it will be necessary to get rid of them. The procedure is carried out by vacuum cleaning of the internal reproductive system. Washing with a special syringe of the uterine cavity with saline is also used to exit postpartum residues.

True type treatment

True look. The variant of the disease is eliminated a little longer. The gynecologist prescribes and conducts therapy based on the factors that caused the disease. There are ways to get rid of the delayed reverse development of the uterus of the true type.

Methods of influencing the contractile activity of the genital organ:

• medication;
• herbal medicine;
• with the help of LFC.

Medicines. For faster involution of the uterine muscles, contracting drugs are used. This helps to restore the tone of the muscles of the genital genital organ in a couple of days after labor. These include oxytocin and derivatives, as well as preparations based on ergot. Stimulants are not used while breastfeeding.

ethnoscience widely used for delayed uterine involution. Basically, it is prescribed as an additional treatment for pathology. It is forbidden to take decoctions and infusions without a doctor's prescription, as there are side effects that can aggravate the woman's condition.

The following plants are used:

• nettle;
• birch leaves;
• horsetail;
• yarrow;
• shepherd's bag.

It is realistic to collect herbs and leaves on your own, but it is better to buy a ready-to-use product at a pharmacy. The use of infusions and decoctions temporarily affects the taste of breast milk, so a lactating mother needs to carefully plan the time of taking the medicine. If the baby is prone to allergies, many plants are forbidden to use because of the risk of a reaction to them. Therefore, patients use decoctions as a solution for douching.

Physiotherapy. A woman needs to be active in order to prevent postpartum pathology from progressing. Gymnastic complexes will improve blood circulation in the uterus.
Kegel exercises help with the problem. The essence of the technique is the alternate relaxation and contraction of the muscles of the vagina and perineum. To check for atony of the uterine muscles, urination is delayed. If you managed to do this, then everything is in order with muscle tone.

Kegel exercises for subinvolution of the uterus:

1. delay (lying on your back with bent legs tighten the muscles of the vagina and keep in good shape for 8-10 seconds);
2. wave (alternate tension of the anus and uterus);
3. elevator (try to pull the penis into yourself and lift it up, and then lower it).

Breastfeeding promotes proper involution. If there are no tingling and cramping pains in the abdomen when the child sucks the breast, this indicates the presence of pathology in the woman. The organ is passive and does not contract.

Forecast and prevention

The pathological condition responds well to treatment, therefore, it has a positive prognosis. Prophylaxis is recommended to reduce the incidence of subinvolution after B-lynch sutures during gestation.

Special staples are installed to stop bleeding. If the problem with contractile activity manifested itself after childbirth, there are risks of resuming the anomaly in the future.

There is a possibility that subinvolution during menopause will overtake a woman again due to an imbalance of hormones. Patients with complex labor, polyhydramnios or rapid labor are prescribed hormonal drugs on the first day after the birth of the child.

You should start training the uterine muscles long before the date of birth. To do this, expectant mothers attend special courses to prepare for labor and motherhood.

Excessive attention to yourself during pregnancy will not harm, but will only protect the woman from postpartum complications. Timely detection of symptoms of incorrect involution quickly eliminates pathology.

Subinvolution of the uterus after childbirth requires diagnosis. Upon receipt of the results, the obstetrician will prescribe treatment depending on the type and cause of the disease. The main thing is to seek help in time, before the disease develops into a chronic form.