After birth, a woman for some time observed from the genital tract. Such selection is called postnatal lohiyami and associated with healing of the wound surface in the uterine cavity. At discharge after childbirth, you can determine whether normally occurs postpartum period, and did not arise whether any complications (eg, endometritis). But not all young mothers know what isolation are considered normal, and when to seek medical attention. Often complicated by postpartum uterine bleeding, which is associated with the violation of the contractile ability of the uterus or the remains of part of the placenta. That is why a woman after the birth should be seen by a doctor no less than in the period of pregnancy.

When there lochia

Postnatal discharge, or lochia, are connected with the process of involution (the inverse reduction) of the uterus, which begins immediately after the birth afterbirth (placenta). The composition of lochia include red blood cells, white blood cells, platelets, plasma and moribund epithelium. There are early (the first two hours after birth) and late postpartum (lasts six to eight weeks) period. In the first two hours after delivery in women observed heavy bleeding, which should not exceed 400 mL or 0, 5% of body weight. The more intense the release, tend to indicate Is hypotonic bleeding (uterus does not contract) or unsutured breaks. To prevent hypotonic bleeding postpartum women immediately after separation of the placenta is administered oxytocin or metilergometrin (reducing agents), as well as empty the bladder with a catheter, and placed on the lower abdomen cold.

After the expiration of the early postpartum period, the woman transferred to the ward, where there is an average of five - six days. At this time, postpartum discharge have bloody character, but their number is gradually decreasing. Often, while in the post-natal ward, the woman feels small cramps in the abdomen Abdominal pain: when to sound the alarm? That is associated with uterine contractions. It is also possible strengthening precipitates motion palpation doctor or abdomen. Before discharge, postpartum discharge becomes brown and resemble menses.

Prevention of late postpartum hemorrhage

In order to prevent late postpartum hemorrhage is necessary to observe a few rules:

• empty the bladder regularly (about every three hours) and intestines, as crowded bowel and bladder hinder the normal uterine contractions;
• breast-feeding to produce on demand (sore nipples allows release of oxytocin);
• horizontal puerpera should increasingly be on the stomach that prevents postpartum discharge delay in the uterus;
• three - four times a day to put a heating pad on your stomach with ice (this measure enhances uterine contractions).

The changing nature of discharge

If you change the nature of postpartum discharge, seek medical advice. Examples of these cases include:

• Lohiometra

Lohiometra - a cluster of postpartum discharge in the uterus, which is due to its bend and overstretching (large fruit, weak tribal forces, polyhydramnios and multiple pregnancy). Symptoms of the disease - is the sudden cessation of emissions. Treatment lohiometry is to shorten the appointment means (Oxytocin). In the absence of effect of conservative treatment resort to scraping the uterine cavity Curettage - how dangerous it is? .

• Endometritis

Endometritis - an inflammation of the uterus Inflammation of the uterus: required hospitalization Which is characterized by the appearance of purulent, foul-smelling discharge. With the development of endometriosis is assigned to antibiotic therapy, and reducing agents. Often endometriosis is a consequence of which developed lohiometry.

• Hemorrhage

Postpartum hemorrhage can occur at any stage of the postpartum period, including a couple of weeks. The woman says strengthening bleeding Spotting - it is important to rule out pathology   after they have practically ceased. One reason for the late postpartum hemorrhage is the presence of slices of the placenta in the uterus. Treatment consists of surgical removal of the remnants of placenta.

Anna Sozinova

Pregnancy - a difficult period, during which both the woman and the fetus could pose many dangers. One of these dangers - the insufficient supply of oxygen to the tissues of the fetus. In this condition more often affects the brain, resulting in the child's body may occur various violations.

What is hypoxia and why it develops in the fetus

Hypoxia (oxygen deficiency, anoxia) - a condition that develops when the body's insufficient oxygen supply to tissues, or in violation of its assimilation.

Hypoxia can occur against the backdrop of a violation of the structure of the placenta and its blood circulation in late toxicosis of pregnancy, exposure to drugs and other harmful factors. This leads to chronic fetal hypoxia associated with decreased oxygen in the blood, which causes dysfunction of the central nervous and cardiovascular systems, the regulation of homeostasis (constancy of the environment within the body), increased permeability of blood vessels and so on.

Fetal Hypoxia is a major cause of damage to the central nervous system of the fetus and newborn with various violations of the physical and psychological development of the child, with the degree of abnormality depends on the duration and severity of fetal hypoxia.

In order to avoid disastrous effects of hypoxia on the fetus, the pregnant woman should regularly be seen in the antenatal clinic. In the process of examination and additional methods of diagnosing fetal hypoxia will be promptly identified and treated.

There are acute and chronic fetal hypoxia. Acute fetal hypoxia occurs more often in childbirth. Chronic fetal hypoxia, which lasts more than a week, usually occurs on the background of a long proceeding diseases of the pregnant woman.

Diagnostics

The very pregnant woman can not feel any discomfort during fetal hypoxia. However, during an inspection of an obstetrician-gynecologist may suspect hypoxia, listening to the heartbeat of the fetus.

In order to confirm fetal hypoxia it is currently the most widely used method of CTG - monitor observation of the fetal heart rate. This estimated heart rate (heart rate, the rate - 120-160 u. / Min), the fruit, rapid changes in heart rate from beat to beat (oscillations, normally their amplitude should not exceed 3-6 cycles per minute), and slow changes in heart rate ( aktseleratsii - normally can be isolated and decelerations - there should be no). At the present time to increase the accuracy of diagnosis of fetal hypoxia used computer decryption kardiotokogramm.

To determine the fetal movement applies aktografiya - registration of movements via ultrasound.

In order to improve the diagnostic accuracy and precision of the forecast data for the fruit of all the studies evaluated in the complex, resulting in a calculated fetal biophysical profile (BFN). The normal state of the fruit is graded 8-10. Rank 7 points require re-examination. In assessing the points 4-6 start treatment of fetal hypoxia. In assessing the prognosis of less than 3 points to the fetus is unfavorable.

It is currently being developed and implemented in the practice of antenatal study of the volume and speed of blood flow to the blood vessels of the uterus, umbilical cord and fetal ultrasound Doppler method.

The presence of fetal hypoxia and some say blood biochemistry.

Signs

The main signs of fetal hypoxia: violation of the heart rate (heart rate initially accelerates and then slows down), first fetal heart tones are more sonorous, and then more and more deaf, impaired heart rate. Further, we can note a decrease motility of the fetus.

Treatment of fetal hypoxia

Treatment of chronic fetal hypoxia should begin with the treatment of diseases caused such a condition (acute and chronic diseases, pregnancy complications). Pregnant woman have to abandon the use of any negative effects on the fetus substances (smoking, alcohol, drugs, self-administration of any drugs, and so on).

Of great importance are a balanced diet with adequate protein, fats, carbohydrates and vitamins, protective mode (and sometimes bed), healthy sleep Dreams: how to understand our dreams , walks in the open air.

To remove the oxygen deficiency use inhalation of oxygen, drugs that improve the flow of blood, including the blood flow in the mother-placenta-fetus. To improve the metabolism prescribe drugs that do not have a toxic effect on the fetus, such as aktovegil.

The best prevention of fetal hypoxia - the right way of life and regular monitoring in the antenatal clinic of the pregnant woman.

Galina Romanenko