The Hole congestion (Synonyms: Weekly river congestion, Lochialstau, Lochiometra) is a disease that occurs in women in childbed. The weekly flow that does not go out or that goes out poorly can be associated with unspecific complaints and is therefore not taken seriously by some young patients. Nevertheless, the woman who has recently given birth should contact her gynecologist as soon as possible.
What is hole congestion?
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The Hole congestion is a weekly bed sickness that is characterized by low or cessation of weekly flow. She will too Lochial jam and Weekly river congestion called. The postnatal wound secretion, which normally flows out of the vagina without any problems, accumulates in the uterine cavity.
The uterine lining, which is sore after the placenta and remnants of the membrane, is normally protected from infections by the excretion of the weekly fluid, and can heal. However, if the holes become blocked, the holes made up of dead tissue, bacteria, white blood cells, blood, serous fluids and vaginal secretions decompose.
In the worst case, it comes to uterine inflammation and - if the pathogens migrate to the ovaries - to fallopian tubes and ovarian inflammation. In very rare cases, the young mother can even get life-threatening blood poisoning.
causes
The congestion of holes can have various causes. During caesarean sections and natural births, a cervical spasm or an accumulation of clotted blood (coagula) can lead to a narrowed or completely closed cervix. The remains of the egg membrane that are not excreted can also block the cervical canal.
In addition, a backward or forward-facing uterus (retroflexio uteri or hyperanteflexio uteri) can be responsible for the formation of a congestion of the holes. The cervix is kinked so that the weekly flow cannot drain through the vagina. Even an overcrowded bladder or rectum can cause lochial congestion.
Symptoms, ailments & signs
The main symptom of puerperal disease is of course the absence, abrupt cessation or the insufficient amount of wound secretion from the uterus. The woman who has recently given birth gets a high fever (more than 38 ° C) during the first two to seven days after giving birth. Your uterus is greatly enlarged and can be easily felt after emptying your bladder. It is soft to the touch, but hurts when light pressure is applied to it.
In addition, there are usually severe abdominal pain and unspecific symptoms such as headache and earache. The forehead headache is piercing to pulling and emanates from both temples. Since these symptoms also occur in connection with other diseases, hole congestion is sometimes not taken seriously. If the weekly flow is only reduced, the excreted secretion often has a foul odor.
Instead of immediately contacting the gynecologist, some young mothers prefer to intensify their hygiene measures because they have the impression that it is a hygienic problem. If the woman who has recently given birth notices that the weekly flow suddenly stops a few days after the birth or that only little fluid is secreted, she should consult her gynecologist as soon as possible.
Diagnosis & course of disease
The congestion of holes can be seen very clearly in the ultrasound of the lower abdomen. The doctor can see clearly that the uterus is full of fluid. Palpation of the uterus reveals that the uterus is greatly enlarged, which indicates insufficient regression.
Complications
The congestion of the holes usually leads to a relatively high fever and thus to a severe exhaustion of the patient. The quality of life is also significantly reduced by this disease. Those affected feel tired and there is a reduced resilience. There is also pain in the abdomen and head.
This pain can also spread to neighboring regions. Pain at night also leads to insomnia and possibly depression. In many cases, the hole congestion is diagnosed late because the symptoms do not appear particularly dangerous. However, with this disease an immediate examination by a gynecologist is necessary to avoid complications.
The uterus can be greatly enlarged due to the congestion of the holes and can no longer regress. The hole congestion can be treated with the help of various drugs or antibiotics. There are no complications and the symptoms disappear relatively quickly. The symptoms can also be limited by various means of self-help. If the treatment is successful, there are no further complications and the life expectancy of the patient is not reduced by the congestion of the holes.
When should you go to the doctor?
The body of a new mother performs at its best in the days and weeks after the birth. At the same time, it is susceptible, which is why the woman concerned should definitely consult the gynecologist in the event of unusual symptoms. A hole congestion is therefore a case for the gynecologist from the first moment of suspicion. It takes weeks for the inside of the uterus to heal completely. Until it is so far, the accumulated weekly flow represents a high risk of infection. The first symptoms of an infection can appear just a few days after the beginning of the congestion of the holes. This can increase to puerperal fever and be a life-threatening risk for women even today.
In earlier centuries and in parts of the world with less consistent medical care and hygienic standards, this is still one of the most common causes of death among young mothers. A hole congestion recognized early enough can be treated well, and depending on the cause, the woman can even dispense with inpatient admission. If, on the other hand, it was only noticed after the first symptoms appeared, it can make sense to accept hospitalization for observation. The babies of the patients are usually also welcome in the maternity ward, so that there is no need to separate mother and child for the treatment of the congestion of holes.
Therapy & Treatment
Hole congestion is usually eliminated with a combination of different applications. To relax the cramped cervix, the doctor gives the patient antispasmodic medication (antispasmodics) such as Buscopan. A brief infusion of oxytocin triggers after-pains. The uterine muscles contract, which then triggers the weekly flow.
The contraceptive medication can also be administered as a nasal spray. Alternatively, the young mother must take methergin as drops or dragees. The drug contains methylergometrine, an active substance that also causes uterine contractions. In the event of an impending or existing abdominal infection, the gynecologist will prescribe antibiotics to kill the pathogens.
If the cervix is blocked by coagula, they are removed immediately so that the jammed holes can flow away again unhindered. The narrowed cervical canal is slightly stretched by the gynecologist. The young mother should keep in daily contact with her gynecologist or midwife until the lochia drains again. It informs him / her about the amount, color and smell of the excreted weekly flow.
In addition to the medical measures carried out in the gynecological practice, the woman who has recently given birth can help ensure that the necessary weekly flow begins again or becomes stronger. She lies down on her stomach at least twice a day with a pillow underneath at the level of the uterus and remains in this position for 30 minutes.This stimulates the contraction of the uterus.
A massage of the lower abdomen in the uterus area can also help to remove the congestion of the weekly flow. Warmth also promotes the Lochien exit. Another effective remedy are hot Sitz baths with chamomile or oak bark extract from the pharmacy. However, the water should only reach up to the navel.
Since the lochia are sometimes infectious, it is advisable not to immerse the breasts in water. Applying a heat pack can also help. If you like tea, you can also prepare a shepherd's purse or lady's mantle tea to remove the congestion of holes.
Outlook & forecast
Normally the prognosis for hole congestion is favorable. Medical treatment is initiated which, under optimal conditions, shows a sufficient effect after a short time. The patient should be completely symptom-free within a few weeks. Long-term complaints are usually not to be expected. If the person concerned supports the healing process with regular massages of the lower abdomen, an improvement in the situation is documented for many in the following hours. In addition, other self-help measures can be taken that are helpful for a good prognosis. It is therefore also possible to achieve freedom from symptoms without having to use medical care.
However, to avoid complications or irregularities, it is not recommended. A combination of medical care and self-initiated measures is ideal. Surgical intervention is necessary in the event of severe disease. This is done routinely and is usually without any further complications. In exceptional cases the disease progresses unfavorably. Sepsis can occur. This is a potential threat to the patient's life, as the blood poisoning can be fatal. For this reason, if the symptoms increase, you should immediately work with a doctor so that the prospect of a good recovery is maintained.
prevention
So that the weekly flow does not become blocked, the young mother should consistently perform her postpartum gymnastics for regression. Mobilization right after giving birth (getting up frequently) can also help prevent the disease. Regular breastfeeding of the baby ensures that the body releases more oxytocin, which stimulates the contraction of the uterus and promotes the weekly flow.
Aftercare
Since hole congestion is generally very good and easy to treat, follow-up care in this case is more of a preventive nature. However, caution should be exercised if depression develops. Then it can be advisable to get professional psychological support in order to avert a solidification and to bring the quality of life back to the usual level as quickly as possible. The help of friends and family can have a lasting positive effect.
You can do that yourself
The patient should take care of herself if the holes are jammed. The organism needs rest and should not be overwhelmed. An adequate supply of fluids is also important. A fever occurs when the holes are blocked. In the worst case, this can lead to dehydration and dehydration in the event of a lack of fluids. Since this is a life-threatening condition, it is important to be careful how much fluids were consumed each day.
A sufficient supply of heat is also helpful. If the abdomen is warmed with hot water bottles or electric blankets, this promotes the weekly flow. Sitz baths or the consumption of warm teas are also recommended. Supportive massages of the abdomen can be performed. With light pressure and circular movements, the circulation is stimulated. This makes it possible to minimize or resolve the congestion. The massages can be carried out independently by the patient at any time according to their own needs.
Relaxation techniques can be used to relieve pain and build wellbeing. Inner forces are mobilized and stressors are reduced through a meditative state or autogenic training. Avoid excitement and hectic. Conflicts or other discrepancies should be postponed so that no new stressful situations arise. On the other hand, optimistic and joyful conversations with fellow human beings are helpful.
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