Abundant period with clots after delivery

Restoration of the monthly cycle after childbirth suggests that the woman's body comes back to normal after a long period of bearing, birth and feeding of the child. However, this recovery process does not always proceed smoothly and predictably. Some women can complain about the irregularity of menstruation, and others are concerned about the plentiful monthly after childbirth. What actually affects the quality and periodicity of the menstrual cycle, and what changes occur in the female body after childbirth?

[1], [2], [3]

Epidemiology

According to various data, the occurrence of abundant periods after birth varies between 40-60% of women. The frequency depends on the characteristics of the course of pregnancy and labor, on the presence of concomitant diseases and on the age category of women.

[4], [5], [6]

Causes of the copious monthly after birth

The bleeding that occurs in a woman soon after delivery is not considered menstrual. This lochia - the discharge of blood with the elements of the endometrium, which is a wound separable from the uterine cavity. Even in the norm, such discharges at first can be quite abundant: women are often forced to use urological pads instead of the usual ones to cope with the problem.

Within several months of the postpartum period the female organism is gradually restored: the uterus acquires the former volumes, the hormonal balance regains, the disturbed blood circulation stabilizes.

Those young mothers who did not breast-feed the baby, menstruation can resume after 2 months after the birth of the baby. However, this process is very individual and can vary considerably. The first months can be as very abundant, and scarce - and this is also individually.

[7]

Risk factors

The risk of the appearance of the first profuse monthly after childbirth is increased in such cases:

• if there were difficult births;
• if a caesarean section was used as a delivery;
• if a woman previously had chronic pathologies of the reproductive organs;
• if after birth the woman has inflammations in the genitals;
• if there is a lack of vitamins and minerals in the body;
• if a low hemoglobin level was diagnosed in a pregnant woman;
• if a woman is often stressed or in a depressed state.

The pathological cause of profuse menstruation in the postpartum period is sometimes the hyperplastic changes in the endometrium - a proliferation of tissue that occurs as a result of a violation of the balance of hormones or significant tissue trauma during childbirth.

[8], [9]

Pathogenesis

The normal indicator of the volume of lost blood at the first monthly after delivery is not more than 50 ml during the entire menstrual period. If we talk about profuse menstruation - it's such that blood loss is up to 80 ml. If the gasket has to be replaced more often than once in 2 hours, then there is reason to suspect pathology.

Abundant blood loss, which can be considered a variant of the norm, may be due to:

• overgrowth of the uterine organ during childbearing, which caused an increase in the number of endometrium;
• a strong hormonal reorganization.

It is clear that the desquamated endometrium should be removed from the uterine cavity, and this occurs during menstruation. With the blood come out particles of tissue, which can look like small clots - and this is also considered a normal indicator. However, such plentiful monthly after birth should not be repeated from month to month - with time (in 1-3 months) the cycle usually gets better and becomes the same as before pregnancy.

[10], [11]

Symptoms of the copious monthly after birth

The first months after the birth of a baby can really differ significantly from those that a woman used to observe before her pregnancy. And here, in addition to the actual bloody discharge, there may be other symptoms: for example, the appearance of clots, discoloration, odor, general discomfort, etc.

First, it is important to remember the first signs that you need to go to the doctor urgently:

• frequent change of gaskets (once every 2-3 hours);
• duration of bleeding more than a week;
• bright scarlet color of discharge;
• significant abdominal pain during menstruation;
• the appearance of an unpleasant odor of excreta.

With a strong loss of blood during profuse periods after birth, there may be signs of an increasing shortage of hemoglobin:

• chronic fatigue, sleep disturbances;
• frequent dizziness and weakness, especially in the morning;
• short temper, irritability;
• blanching of the skin;
• deterioration of the hair, nails, skin.

If the first monthly after delivery is abundant, then it is necessary to make an appointment with a female doctor. The same should be done if the breastfeeding phase is completed, and the monthly cycle is not in a hurry to recover.

Abundant menstruation with clots after childbirth can act, both as a norm, and as a pathology. It is certainly impossible to independently determine the cause of such a course of events. Therefore, a visit to a doctor in the postpartum period is usually considered a planned one: one can not exclude the possible development of diseases, complications, repeated pregnancy and even premature menopause.

It is generally believed that the first months after birth can not appear until the young mother feeds the baby with breast milk. Nevertheless, the plentiful monthly after delivery with breastfeeding is also possible, and this is due to the change in the balance of the hormone prolactin in the female body. To accurately identify the cause of such a change, it will be necessary to pass tests for the hormonal background - perhaps in the future, a medical correction of this disorder will be required.

[12], [13]

Complications and consequences

Unfortunately, after delivery, when all the most unpleasant things seem to be over, all sorts of complications and consequences can arise. Such consequences can become serious painful processes: bleeding, infectious and purulent diseases, anemia, etc.

The most severe consequences are:

• infection, for example, staphylococcus infection. The causes can be acute inflammation during pregnancy, chronic infections in the body, prolonged dehydration;
• endometritis is an inflammatory process in the uterus. The disease can begin its development after untreated sexual infections, as well as after a two-handed uterine examination.

Any suspicious symptoms that have arisen in the postpartum period, including the plentiful monthly ones, should always be alarming and cause an early visit to the gynecologist. It is impossible to delay anyway: such complications are too serious.

[14], [15], [16]

Diagnostics of the copious monthly after birth

When visiting a doctor, a woman should tell him about all the complaints and signs of profuse menstruation. Already at this stage of diagnosis, a doctor may suspect this or that pathology, if any.

Then follow some diagnostic procedures:

• examination on a gynecological chair with an assessment of the amount, consistency and quality of vaginal discharge;
• taking smears for examination (to determine the infection or its reaction to certain medicines);
• general blood test, determination of hemoglobin level and presence of signs of inflammatory process in the body;
• blood tests to assess the quality of coagulation;
• determination of the hormonal level in the blood.

Instrumental diagnostics in case of copious periods most often involves the ultrasound examination of the pelvic organs. Ultrasound can detect and identify diseases of the uterus, ovaries, tubes, and also track their condition. In some cases, it is advisable to replace ultrasound with magnetic resonance imaging.

From practice, the above diagnostic procedures are sufficient to identify any pathology in the reproductive field, which could lead to too abundant monthly after childbirth.

[17], [18], [19]

Differential diagnosis

Differential diagnosis in this case can be carried out:

• with hormonal disorders;
• with inflammatory processes in the uterus;
• with tumors, both benign and malignant;
• with violations of the blood coagulation system;
• with hyperplasia of the endometrium, erosions and endometriosis.

Treatment of the copious monthly after birth

After revealing the true cause of the plentiful monthly after birth, the physician will proceed to treatment, which is administered individually.

If the doctor's appointment was timely, or the cause of this condition is not critical, then the treatment can be performed on an outpatient basis. In other cases, the patient may be placed in a hospital.

In most cases, such drugs are prescribed to stabilize the menstrual cycle:

• Haemostatic agents (Dicinon, Water Pepper extract, Aminocaproic acid);
• anti-anemic drugs (Fenyuls, Ferrum-lek, Sorbifer);
• drugs-components of blood (plasma, erythrocyte mass);
• vitamins, as a restorative and vasoconstrictor (Ascorutin, ascorbic acid, cyanocobalamin, folic acid, Vikasol).

After stabilization of the number of discharges, measures can be taken to prevent further violations of the monthly cycle. This may be a course of hormonal therapy (oral contraceptives or gestagens), antibiotic therapy, etc. If the doctor has found an intrauterine pathology, then treat the corresponding disease.

As a symptomatic treatment of profuse monthly after childbirth is most often used:

	Dosing and Administration	Side effects	Special instructions
Dicycin	The haemostatic agent is prescribed at ample monthly in a daily dosage of 10-20 mg per kg of body weight. The dose is divided into 3 or 4 doses.	There may be dizziness, headache, nausea, allergies, redness of the face, lower blood pressure.	Before you start taking the drug, you need to make sure of the physiological cause of bleeding.

	Dosing and Administration	Side effects	Special instructions
Etamsylate	With abundant monthly after birth, the drug is used intramuscularly, 1-2 ampoules 3-4 times a day.	There may be a headache, hypotension, abdominal pain, allergies, bronchospasm, back pain, hives, dizziness.	In the treatment of etamzilate, breastfeeding is temporarily suspended.

	Dosing and Administration	Side effects	Special instructions
Vikasol	At plentiful monthly after sorts Vikasol  accept on 15-30 mg a day, for 2-3 times. Duration of reception is set individually.	There can be skin rashes, redness of the skin, the phenomenon of bronchospasm.	Vikasol is not used with a tendency to thrombosis.

	Dosing and Administration	Side effects	Special instructions
Aminocaproic acid	With abundant monthly after birth, the drug is administered intravenously in the form of a dropper, with an individually selected dosage.	There is dizziness, attacks of nausea, noise in the head, difficulty in nasal breathing, lowering of blood pressure, convulsions.	At the time of treatment, lactation should be discontinued.

Physiotherapeutic treatment during profuse menstruation is not shown - spotting from the genitals is one of the contraindications to the conduct of physiotherapy. It is impossible to conduct warming up of organs with oncology, endometriosis, benign tumors. Only in some cases, magnetotherapy can be prescribed - a procedure that removes inflammation and soothes pain.

Alternative treatment

From alternative medicine, you can borrow a large number of recipes to reduce the abundance of secretions and stabilize the monthly cycle. However, they can be used only after a visit to a gynecologist.

• With strong secretions should take 1 tbsp. L. Berries of viburnum and pour them 200 ml of boiling water, boil for half an hour. Next, the broth should be drunk at 1 tbsp. L. Three times a day before meals.
• It is useful to drink potassium juice, sweetened with sugar or honey, in an amount not less than 3 st. L. 4 times a day.
• Abundant monthly can be brought to normal if you prepare the following remedy: boil the peel from seven oranges in 1½ liters of boiling water until there are not more than half a decoction of decoction, which is filtered and sweetened with honey. The broth is drunk 200-300 ml 30 minutes before meals three times a day.

In addition to alternative means, with abundant monthly after birth, you can also use prescriptions for medicines based on herbs.

[20], [21]

Herbal Treatment

• 1 tbsp. L. Strawberry leaves are poured overnight 0.5 liters of boiled water. In the morning, strain the medicine and drink 100 ml daily.
• We brew 1 tbsp. L. Field horsetail in 250 ml of boiling water. We take infusion of 1 tbsp. L. Every 2-3 hours.
• We prepare the collection on the basis of equal parts of herbs of wormwood, sporis, shepherd's bag, clover, nettle, and also rhizomes of licorice and bark of Kalina. It is also useful to add hips of rosehip to the mixture obtained. Fill 2 tbsp. L. Mixture with one liter of boiling water and insist in a thermos for 5-6 hours. During the day, you must drink all the medicine you have received.
• We put in a thermos 3 tbsp. L. Parsley, pour 0.5 liters of boiling water, we insist for 5-6 hours infusion take 100 ml 30 minutes before meals: in the morning, before dinner, before dinner and at night.

Homeopathy

Abundant months after childbirth - this problem is often helped to solve homeopathy - a special science involving the use of certain drugs with a minimum risk of side effects and the maximum possible benefit for the body. With abundant periods, the main task of homeopathic remedies is regulating the hormonal background and stabilizing the duration and quality of the menstrual cycle.

What drugs are most relevant for copious monthly after birth?

• Cyclodinone - with copious monthly intake of 40 drops in the morning, with water, before breakfast. The course of admission lasts no less than 3 months, without interruptions for the time of menstrual bleeding. Very rarely the drug can cause allergies.
• Ovariamine - with copious monthly after birth take 2 tablets twice a day, for a month. It is recommended to suspend breastfeeding for the duration of treatment.
• Ovarium compositum - with a plentiful monthly after delivery, prescribe injections of the drug for 1 ampoule once every three days, intramuscularly. Duration of treatment may vary, depending on the indications.
• Remens - with plentiful monthly after childbirth appoint 10 drops three times a day, for 3 months. Rarely can an allergy to the drug develop.

Operative treatment

In case of copious monthly after birth the operation is prescribed only in cases when it is required to remove the tumor process or endometrial hyperplasia. In this case, the histological analysis of seized tissues is performed.

The operation for the complete removal of the uterine organ - hysterectomy - in women with copious periods is carried out only in very serious situations, when the issue of preserving the genital function becomes secondary. This happens rarely: in the vast majority of cases, the problem is solved by a drug-conservative route.

Prevention

The appearance of irregular and pathological first months after childbirth can be prevented if certain recommendations are followed immediately after discharge from the hospital.

• It is important to eat fully, drink a sufficient amount of liquid.
• If possible, stress and stress should be avoided.
• It is necessary to treat any diseases in a timely manner, as well as to undergo all the examinations recommended by the doctor.
• It is necessary to discuss with the family the possibility of a full-fledged rest of the young mother, and also provide her with a quality sleep.
• Periodically monitor the blood test to determine anemia in time.

Two weeks after childbirth, and in the future it is necessary to visit a gynecologist for preventive examinations - this is a very important and necessary procedure that allows to keep the young mother healthy for a long time.

Forecast

If a woman noticed a profuse period after birth, then panic is not worth it: perhaps this is one of the variants of the physiological norm. However, and completely ignore this state also does not follow: a specialist's consultation should be mandatory. Firstly, if there is no pathology in the body, this will allow the woman to calm down and not to be in vain. Secondly, if there is a violation, then a timely appeal to a medical specialist will solve the problem faster and better, which will significantly and positively affect the future forecast.