During pregnancy in the body of a womanthere are numerous changes necessary for the woman to be able to bear the child. And after birth, these organs gradually come back to normal. And, of course, the uterus undergoes the most changes. And complications happen more often - the uterus after sorts sometimes comes to the form far not at once. This is exactly what will be discussed in this article. However, in order to get a full idea of what happens to the uterus after childbirth, and what complications can lie in wait for the postpartum period, you need to know exactly how it changes during childbirth. Then, and understand everything will be much easier, and therefore in time to notice the problem.
What is the uterus?
First, let's have a little refreshing in the memoryknowledge of what the uterus is. Doctors call the womb a hollow muscular organ of the female reproductive system. Uterus is a unique organ of its kind - it is the fetus that develops in it, because of which the size of the uterus during pregnancy increases tens of times, returning after birth to its original position. The uterus consists of two main parts - the body of the uterus itself, which is located in the small pelvis, and the cervix. The body and cervix of the uterus are divided among themselves by an intermediate tissue, which is called the isthmus. Uterus is pear-shaped, located neck down. And the highest point of the uterus is called the bottom of the uterus. The walls of the uterus themselves consist of three different layers:
- The outer layer of the uterus is the perimeter, which is also called the serosa.
- The inner layer of the uterus is the endometrium.
The mucous membrane of the uterus changes its structure independing on the phase in which the menstrual cycle is located. If fertilization has occurred, the endometrium becomes more friable so that the fetal egg can easily be implanted into it. And nutrients and oxygen at first, until the placenta has not yet formed and started to function properly, the fetus also supplies the endometrium. If the pregnancy does not occur, the mucous membrane of the uterus (endometrium) is separated from the walls and is removed from the uterus cavity along with menstrual secretions.
- And, finally, the middle, intermediate layer of the uterus is the myometrium.
Myometrium constitutes the main body of the uterus, andit allows you to increase so much the uterus in its size during the gestation of the baby. During this period, in this uterine layer, the main mass of changes, one way or another associated with the course of pregnancy. In order for the uterus to grow as the child grows, muscle cells - myocytes, begin to intensively divide, thus forming muscle fibers. In addition, the growth of the uterus is also provided by thickening and elongation of the muscle fibers. By the way, this happens to a greater extent already during the first half of pregnancy. Normally, a woman of reproductive age has a uterus about 8 centimeters in length, and a thickness of about 5. If the woman has never given birth, the weight of her womb is about 50 grams, while those who have given birth have about 100 centimeters. At the end of pregnancy, the size of the uterus increases very much - in length it becomes about 38 centimeters, and its weight without fetal membranes and the baby is about 1200 grams. In the same case, if the future mother has polyhydramnios, or the pregnancy is multiple, the weight of the uterus can be even more - up to 1500 - 1800 grams. The uterus begins to increase at about 6 weeks of gestation - this corresponds to the second week of delay in the onset of menstruation. And the first time the uterus increases gradually - at first it increases in anteroposterior size, and then, after a short time - and in the transverse. In the first weeks of pregnancy with palpation, the doctor determines the asymmetry of the uterus - one of its angles extends more than others. This protrusion is explained by the fact that it is in this place that the fetal egg is fixed, which is growing rapidly. Literally in a few weeks the fetal egg will become large enough to fill the entire uterine cavity, which will acquire a symmetrical shape. By the end of the eighth week of pregnancy, the size of the uterus is doubled, and only two weeks later - three times. By the end of the first trimester - at 12 weeks of pregnancy, the uterus increases fourfold and comes out of the small pelvis, beyond the upper edge of the pubic joint.
Examination of uterine size
In order for the doctor to determine whetherthe pregnancy takes place, the doctor must assess the position of the uterus, its size and density. For this, a two-handed study of the uterus is necessary. For this, the doctor inserts the middle and index fingers of the right hand into the woman's vagina. And with the left hand the doctor very gently and gently presses on the anterior abdominal wall. Approaching the fingers of both hands, the doctor will feel the body of the uterus, determining its anatomical features. However, remember that this method of determining the size of the uterus is relevant only in the first twelve weeks of pregnancy. After that, the uterus goes beyond the lower edge of the small pelvis, so the doctor can feel it through the abdominal wall. It is from this time interval that the doctor begins to measure the abdominal circumference and the height of the standing of the uterine fundus. This term is abbreviated as "VMD". In order to measure AMD and abdominal circumference, the doctor will need either a tachometer or at least an ordinary centimeter tape. Before the study, the expectant mother should visit the toilet and empty the bladder. During all these measurements, the woman should lie on her back. In order to assess the course of pregnancy and fetal development, doctors compare the results with established and generally accepted standards. However, remember that, however that may be, this is only averaged data, therefore, in each specific case, the doctor in evaluating the status of the uterus will certainly take into account the individual characteristics of each particular woman - her physique, the course of pregnancy and much more. However, the average figures still exist, and they need to be taken into account - a deviation of more than five centimeters is a cause for serious concern:
- 16 weeks of pregnancy - VDM is about 6 - 7 centimeters.
- 20 weeks gestation - VDM is about 12 - 13 centimeters.
- 24 weeks gestation - VDM is about 22 - 23 centimeters.
- 28 weeks of pregnancy - AMD is about 25 - 27 centimeters.
- 32 weeks of pregnancy - AMD is about 30 centimeters.
- 36 weeks of pregnancy - AMD is about 33 centimeters.
- 38 - 40 weeks of pregnancy, the uterus is significantly lowered, and AMD is about 28 centimeters.
As mentioned above, the height of the standing of the bottom of the uterus- the quantity is not constant. It can be affected by the number of amniotic fluid, the number of fetuses to be born - the uterus is stretched more in this case, which means that the height of the uterine fundus will be greater than in normal pregnancy. No less important is the presentation of the fetus - if it is transverse or oblique, then AMD will be smaller than usual. That is why doctors - gynecologists almost never determine the duration of pregnancy for the height of the standing of the uterine fundus. Therefore, such facts as the beginning of the child's movement, the date of the last menstruation, and the results of the ultrasound examination of the fetus are taken into account.
Increased size of the uterus
In the event that pregnancy occursnormally, a woman practically does not feel the increase in the uterus in size, because it happens gradually. However, at the very beginning of pregnancy, a woman can experience quite a strange sensation in the lower abdomen - this is due to the fact that the structure of the uterine ligaments begins to change rapidly, soften. In the same case, if the uterus begins to grow too quickly - because of the hydration or multiple pregnancy, or if the uterus has a backward deflection, or if the uterus has a woman's uterus on the uterus (for example, as a result of cesarean section surgery), or if a woman has an adhesion process, often a woman begins to experience pain, sometimes quite strong. Often, many women hear the advice to endure this pain, ostensibly because it is normal and physiological. However, doctors - gynecologists advise the future mother not to endure the pain, and at the first manifestations of her turn to seek medical help. Only a doctor can really assess the condition of a woman and establish the cause, which led to the emergence of pain. Otherwise, the woman risks not paying special attention to the pain that signals the onset of a spontaneous abortion - a miscarriage. Strictly speaking, neither a pregnant woman, who has already given birth in any case, is unacceptable to try to independently diagnose herself. Often, even the most experienced physician needs time and some additional research in order to accurately establish an accurate diagnosis. And in the event that a woman also turns to a doctor for help untimely, then the most precious time can be irretrievably lost.
What happens to the uterus after giving birth?
What happens to the uterus after the birth of the child? Reduction of the uterus after childbirth begins in a few minutes after the birth of a child. Immediately after delivery, an intensive contraction of the uterus begins to occur in order to separate from the wall and leave the latter. In the first few hours after the birth of the baby, the height of the uterine fundus is about twenty centimeters. Next, the uterus will drop about one centimeter per day for about two weeks. In the event that the contraction of the uterus after delivery is normal, the indicators will be approximately the following:
- The second day after birth - VDM is approximately 14 - 15 centimeters.
- The 4th day after birth - VDM is approximately 11 centimeters.
- The 6th day after birth - VDM is approximately 9 centimeters.
- The 8th day after birth - AMD is approximately 7 centimeters.
- The 10th day after birth - AMD is about 6 centimeters.
Finally, the uterus will restore its shape onlyto the eighth - ninth week after childbirth. However, in this case, it is necessary to take into account some individual factors that may influence this process: the peculiarities of pregnancy and childbirth, breastfeeding of the child, the age of the woman, and the presence of certain chronic diseases. As a rule, women older than 25 years, or those who give birth not the first time, or those who have had a pregnancy with multiple births or with polyhydramnios, the uterus can contract much more slowly. And this means that these women may need medical intervention. The doctor will examine the woman and, if necessary, prescribe her special medications and physiotherapy, which will stimulate a more intensive contraction of the uterus. While the woman is in the hospital, the doctor has the ability to control the rate of contraction of her uterus. However, the uterus is reduced for much longer than the woman is after delivery in the maternity hospital. So, these or other problems can go unnoticed. That is why in no case it is unacceptable to ignore preventive visits to gynecologists. A woman must undergo a gynecological examination in two weeks and a month after the birth of the child. The doctor will assess the condition of not only the uterus, but also the cervix. To the great regret, the cervix after delivery can also leave much to be desired. But the young mother will need a lot of strength and health to care for the most valuable, that only can be in his life - for his crumbs. And in fact, if the problem is not noticed in a timely manner, the risk of developing various complications, due to which a woman may find herself in a hospital, is very high. We advise you to read: