For every woman, pregnancy and the subsequent birth of her baby is not only the happiest period in life, but also the most responsible. That's why special attention should be given preventive measures, and also timely treatment complications that have arisen, one of which is a postpartum polyp.

Not to be confused with a neoplasm that occurs during pregnancy. Such a polyp is considered normal occurrence, not threatening the health of the woman and her unborn child. This is a decidual polyp formed from tissues membranes or placenta. The appearance of decidual formation is considered a natural process during pregnancy, and therefore does not require any treatment.

Symptoms and causes

Placental polyp is a pathological neoplasm that appears from the remnants of the placenta after a miscarriage, abortion or complicated childbirth.

Polyps in the uterus after childbirth

Retained placenta pieces in the uterus with the subsequent formation of a placental polyp can occur for the following reasons:

• Abnormal structure of the placenta with an additional number of lobules;
• disruption of the process of natural separation of the placental parenchyma from the walls of the uterus.

The presence of placental tissue remaining after childbirth can be determined by the following signs:

• Large sizes postpartum uterus;
• pulsating bleeding ( bleeding) with blood clots;
• contractions and subsequent relaxations of the uterus of a cramping nature.

The appearance of a placental polyp can be prevented using the following preventive measures:

• Dopplerography of the uterocircular circulation;
• Ultrasound screening.

The need for routine ultrasound screening exists throughout pregnancy. This makes it possible to timely identify separately located areas of the placenta (additional lobules), ring-shaped, membranous placenta and other developmental pathologies.

Having determined possible risks, the specialist will be able to prevent the development of postpartum complications, which includes placental formation.

Preventive measures are also carried out after childbirth. They are as follows:

• A thorough examination of the postpartum uterus is carried out. If signs of incomplete release of placental tissue are detected, it is mechanically separated and the placenta is removed.
• Immediately after birth, antispasmodic and contractile therapy is used.

Discharge from the uterus of various nature, as well as bleeding and spotting that appeared in the late postpartum period should be a reason to consult a doctor.

Reasons for education

The placenta is a kind of barrier, as well as an instrument of metabolism between the body of a woman and the fetus. During normal childbirth, the placental parenchyma completely leaves the uterine cavity, along with the amniotic membranes and the umbilical cord. However, in some cases a piece of the placenta remains inside, as a result of which a polyp is formed. Therefore, after the placental tissue is released, the specialist must ensure its integrity, that is, the presence of all lobules.

Part of the placenta may remain inside in the following cases:

• The placenta had additional lobules, which remained in the uterine cavity;
• unprofessional management last trimester pregnancy and postpartum period.

Blood clots begin to adhere to the remains of the placental parenchyma, tightly attached to the walls of the uterus, forming a polyp, covered with a crust on top, which is formed from the placental tissue. This happens as a result of a miscarriage, unprofessional abortion, childbirth and caesarean section. Exists many factors, contributing to the development of a polyp, among which the following can be noted:

• Frozen pregnancy without specific manifestations;
• poorly scraped uterine cavity after an abortion or miscarriage;
• incomplete removal of placental parenchyma during cesarean section;
• inappropriate management of the postpartum period.

Symptoms

The pathology has a pronounced clinical picture, reminiscent of natural physiological processes, occurring in a woman’s body after miscarriages and artificial termination of pregnancy, as well as during the postpartum period. But at the same time, bleeding is longer in nature - this is exactly what characteristic feature chorionic polyps.

In addition, on presence of polypous formation indicate the following signs:

• Paleness of the skin;
• fatigue and general weakness;
• frequent dizziness and fainting;
• increase in temperature;
• discomfort or pain in the lumbar region and lower abdomen.

The danger of placental polyp

Placental neoplasm is subject to compulsory treatment. Otherwise it is possible development of the following complications:

• Development of anemia against the background of critical blood loss;
• blood poisoning - sepsis;
• addition of a secondary infection;
• inflammation of the uterine mucosa - endometritis;
• infertility is possible in the future.
• In severe cases - death caused by acute blood poisoning or excessive bleeding.

Bloody discharge that doesn't stop long time, should serve as a reason to consult a doctor. Only a specialist will be able to accurately determine the nature of the bleeding and, if necessary, prescribe surgery.

Many women who have given birth often encounter other types of polyps that appear after childbirth. In particular, neoplasms such as granulation polyps can be noted.

Granulation polyp of the perineum

In some cases, polyps do not form in the uterine cavity, but on the vaginal mucosa. This is a special type of polyp-like neoplasms - granulations, the formation of which occurs at the site of ruptures.

The appearance of granulation polyps depends mainly on the characteristics of the woman's tissues. In this case, the suturing technique and the type of suture material are not particularly important. Polypous growths may appear as a result improper connection of tissues vulva, perineum or vaginal mucosa. This can happen if vacuum extraction is used, during the birth of a large child, numerous ruptures, etc. Other similar neoplasms are often mistaken for granulations - papillomas, condylomas and other structures.

Diagnostic methods

I must say that timely detection pathology significantly increases the chance of complete cure. Therefore, every woman is recommended to visit a gynecologist every six months to undergo scheduled inspection. In such cases, the purpose of carrying out diagnostic measures is the identification of pathological neoplasms.

Initial diagnosis consists of the following procedures:

The final diagnosis is made only after histology of removed polyp tissue.

Treatment

The only way who showed their high efficiency in the treatment of placental formation, the polyp is removed surgically.

There are several ways surgical removal polyp:

• Hysteroscopy.
• Surgical forceps. The operation is performed if it is not possible to use therapeutic hysteroscopy.
• Laser removal.

At the end of the surgical intervention, specialists usually carry out separate curettage uterus. The presence of sepsis (infection) is a contraindication to curettage.

The removed polyp-like tissue is sent for histology to exclude trophoblastic disease (chorionepithelioma, hydatidiform mole, chorionic carcinoma).

Laser treatment of polyps

Today, many clinics and medical centers apply innovative methodology treatment of polyps various kinds- laser removal. This method is especially relevant in the case of existing I have contraindications for complete curettage of the uterus.

Removal is carried out by excision of the polyp using a laser. The operation is absolutely safe, easy and painless. It is thanks to these basic criteria that the method is gaining increasing popularity. Simultaneously with surgical intervention Measures are taken to treat anemia (anemia):

• Taking vitamin and mineral complexes containing iron;
• special diet;
• injections of iron-containing drugs;
• in severe cases - transfusion of blood components (erythrocyte mass, plasma).

Preventive measures

With a purpose prevention of placental polyps The following measures must be observed:

Postpartum placental polyp oz can appear against the background of previous miscarriages and abortions, including criminal ones. It is necessary to understand that any obstetric and gynecological intervention should be carried out only by qualified specialists exclusively in a clinical setting.

Home births, which are becoming increasingly popular, can trigger the development of quite serious complications, including uterine polyps. Therefore, there is no need to put the health, much less the life of the mother and baby, at risk.

To prevent the development of complications after eliminating polypous formation, women should adhere to some recommendations specialists, namely the following:

• Do not exhaust yourself with physical exercise;
• avoid lifting heavy objects;
• abstain from sexual intercourse;
• exclude visiting the beach, baths, saunas.

Many women are horrified by the mere thought of surgical intervention and they start looking alternative ways treatment of polyps. Ladies turn to traditional healers, trying to find medicines that can save them from the problem that has arisen. However, this is the wrong approach.

Firstly, because independent choice medications pose a huge danger to the health and even life of the patient, and, secondly, to cure a placental neoplasm medications is possible only if it is small in size and there are no complications of the disease. In such a situation, the doctor prescribes anti-inflammatory, hormonal and antibacterial drugs.

And what about the application? folk remedies And won't solve the problem at all. In this way, you can only prevent the development of new polyps or alleviate the symptoms of an existing pathology.

If you suspect the development of placental polyps various shapes You must urgently contact a doctor who will prescribe an appropriate examination and determine the appropriate treatment method for you. You should also not forget about regular medical examinations with a gynecologist.

Incomplete expulsion of the placenta is a condition in which, at the final stage of labor, the entire placenta or some part of it remains in the uterus. The final stage of labor is called the third stage, when the placenta is born. Incomplete expulsion of the placenta requires medical care, and you will receive it directly in the maternity hospital.
Normally, the third stage of labor is without medical intervention lasts 10-20 minutes, during which you experience contractions and pushing to help the placenta expel. Sometimes this process can take an hour, and if necessary, it can be accelerated with the help of the same stimulants that are used during childbirth. In this case we are talking about stimulation childbirth, and then the placenta is expelled within 5-10 minutes. The use of stimulation at the birth of the placenta prevents the risk of high blood loss in the mother.
If the placenta has not completely come out, you will receive medical care. Depending on the views of the doctor who delivers the child, and on the course of the birth itself, stimulation will be carried out:

• within half an hour after birth
• immediately after incomplete delivery of the placenta

Why and how does part of the placenta remain in the uterus?

There are three main reasons:

• short uterine tone - meaning that the uterus stops contracting after childbirth or contracts so weakly that the placenta cannot separate from the wall of the uterus
• retention (capture) of the placenta– the placenta is completely separated from the wall of the uterus, but does not come out because it is retained by the cervix
• placenta accreta– part of the placenta is too tightly attached to the wall of the uterus and cannot detach on its own.

Retained placenta can occur when assisted techniques are used to final stage childbirth, when the placenta is pulled out by the umbilical cord. The midwife gives the injection, waits for the placenta to detach, and places one hand on your stomach, as if holding your uterus, while the other hand pulls on the umbilical cord.
If the placenta is separated, it easily slips out of the vagina. But if it is not completely detached, if the umbilical cord is too weak, or if the midwife tugs too hard on it, the umbilical cord may break, leaving the placenta in the uterus. In these cases, it is recommended to push during contractions. However, sometimes the cervix begins to contract rapidly, thereby preventing the placenta from being delivered.
Sometimes it happens that the placenta has an additional lobe (it is usually connected by a separate vessel to the main placenta), which is not separated and/or is retained in the uterine cavity. This is why the placenta is carefully examined after birth: if the doctor or midwife notices a broken vessel, this will raise suspicions that some portion remains in the uterus.
Sometimes part of the placenta is attached to a fibroid or scar from a previous one.
Sometimes a full bladder prevents the placenta from moving forward. In this case, the midwife will place a catheter in the bladder to empty it.

What are the consequences of incomplete delivery of the placenta?

Normally, after the birth of the placenta, the uterus begins to contract to close the bleeding blood vessels. But if a portion of the placenta remains inside, complete contraction does not occur and the vessels continue to bleed.
If, despite the use assistive technologies at the final stage of labor, the passage of the placenta lasts longer than half an hour, and the risk of acute uterine bleeding increases. Large blood loss in the first days after childbirth is also sometimes called postpartum hemorrhage.
If fragments of the placenta are not removed from the uterus in time, severe blood loss and infection may occur. This occurs in 1% of births.

How to treat?

If the final stage of labor is delayed, it is recommended to attach the baby to the breast or stimulate the nipples manually, as this causes contractions of the uterus and the rapid expulsion of the placenta. If possible, take an upright position - the force of gravity can also help.
If you prefer medical intervention, you will be given an injection of oxytocin and the midwife will pull the placenta out by the umbilical cord. When this fails, the placenta has to be removed manually. In this case, spinal anesthesia, or general anesthesia is performed.
Before removing the placenta or part of it, the midwife will insert a catheter for emptying bladder and will do intravenous injection antibiotic to prevent infections. After the remaining placenta is manually removed from the uterine cavity, you will be given intravenous medications to shrink the placenta.
If you continue profuse bleeding Within a few days or weeks after giving birth, you will be referred for an ultrasound to check if there are any pieces of placenta remaining in the uterus. If the suspicions are confirmed, you will be sent to the hospital for surgical removal of the remaining placenta from the uterine cavity. It is performed under anesthesia and is accompanied by the administration of antibiotics.

During my first birth, I had incomplete delivery of the placenta. Is there any way to avoid this a second time?

Unfortunately, if you have already incomplete passage placenta, you risk getting it again. If the previous case was caused by placenta accretion into a cesarean section scar or accreta, then you have a high chance of repeating the previous scenario, and it is difficult to influence the situation.
Incomplete discharge also occurs more often with, since the mature placenta is more easily separated from the uterine wall. So if you have any more premature birth, the risk of a similar outcome is high.
However, if the previous situation was related to stimulation and the cervix closed too early or the umbilical cord broke, then you may want to discuss with your midwife the possibility of not using assisted techniques in the final stages of labor this time. Perhaps it's better to spend it naturally, since in this case the cervix will not close too quickly, preventing the delivery of the placenta.

pochta7 07/23/2008 at 17:39:44

manual examination of the uterus, a piece of the placenta remained - are there complications after this?

something seems to me that this is not very good

• Liera 07/23/2008 at 23:30:59

  You can't joke about this

  They barely saved my mother, severe bleeding began... They barely stopped... The bastards, didn’t they notice...

  vnm 07/24/2008 at 17:19:51

  when was the birth?

  How did you find out about the placenta?

  Natasha and Temka (28.08.04)

  If 20-year-olds are extremely polite to you, then you are older than you think

  Education is an educational process, at the beginning of which the child is taught to speak, and at the end to remain silent.

  • Arina8 07/24/2008 at 21:54:25

    I had it right after giving birth

    and bleeding began, but I have twins, and with such births this often happens

Lyulyam 07/23/2008 at 18:01:13

My godfather had this, really.

5 years ago she gave birth. They didn’t notice right away, a month after giving birth, her health began to deteriorate - weakness appeared, her temperature often began to rise, her milk began to disappear. But with a month-old baby, she had no time for doctors. So she endured it for a month - the milk completely disappeared, I switched the baby to formula, but she became even worse, she began to lose consciousness and started bleeding. Finally, she went to the doctor, but it turned out that they had not noticed a piece of the placenta, but it had already begun to calcify, a little more and the outcome could have been completely sad. They did a cleansing. the fact that she gave birth for 200 euros, and 5.5 years ago it was quite a lot, like with a very cool doctor-manager (this doctor now works in a antenatal clinic - she was demoted).
So this is a serious matter, and after giving birth you should definitely do an ultrasound to check such nuances so that there are no problems.

Friendly family: mother Julia, father Misha and children Bodik (07/09/2002) and Olesenka (01/09/2008)

• creme 07/23/2008 at 19:46:47

  I had this too

  on the day of discharge. The doctor came in this morning and said that I could get ready to go home, but before that they should look at me in the chair to see if everything was fine there. She went to the chair and the doctor said that she didn’t like something. She sent me for an ultrasound, they also looked at the ultrasound twice and said that there was still something left there. :(I am upset and return to the ward, where my husband and mother are already waiting for me to go home, and then the doctor comes in and says that even if they cleanse me today, I will have to stay for another 2 days. :(I am in tears and I say that I don’t intend to stay here any longer. Let them clean me and let me go home :) In the end, they cleaned me up, I lay there for 15 minutes and went home :)

  They also paid a lot of money for childbirth, so is it really impossible to do everything normally from the beginning? Can't they see that there's something left there?
  It was in October 2007

  • rost_v 07/24/2008 at 11:23:57

    the same

    also in October 2006, but I always had the feeling that I didn’t give birth to a placenta at all. It is clear that the day of birth is in my memory as if in a fog - everything is very vague, but even in the first weeks I thought about it and could not remember that I gave birth to the placenta! and during the cleaning they pulled out such a lump! maybe it was her!:) Now... I did cauterization of erosion once in the fall, it was very good, now I’m going to do the procedure to eliminate erosion again - cryodestruction!

Kat_rinkA 07/25/2008 at 23:47:35

I beg you very much - run to the doctor!

listen, you are a woman who gave birth! how can you be so careless?!

you have a piece of bloody tissue inside - what do you think will happen to it if it is there?

La_isla 07/25/2008 at 14:28:31

I developed a polyp from this soil :(

10 months after birth, uterine bleeding began, they cleaned it :(

Katyona 07/23/2008 at 20:35:31

it was like this..

due to reasons (polyhydramnios, poor uterine contractions). Because of this, I spent 5 days in the maternity hospital. The doctor kept hoping that she wouldn’t have to clean it. But I still had to do some cleaning.
So I can say that this is not good at all... and it’s not worth leaving it like that

Curettage of the uterus (curettage) after childbirth is a gynecological procedure in which mechanically Remains of amniotic membranes are removed from the uterus and large clots blood.

In what cases is it necessary to carry out a cleaning procedure after childbirth?

After the baby is born, the placenta (afterbirth) must leave the woman’s body, namely the uterus.

Sometimes, for some reason, for example, due to a tight attachment, the placenta does not come out and remains inside the organ. Also, when the placenta is expelled, parts of it or remnants of other amniotic membranes and tissues may remain in the uterus.

Normally, all this, together with blood clots formed during postpartum healing of the uterus, should pass away in the form of lochia - postpartum discharge.

But if the placenta does not come out, tissue particles remain in the uterus or large blood clots, blocking the discharge of lochia, there is a threat of infection. The remains of the placenta and amniotic membranes will begin to decompose, which will become a favorable area for the development of bacteria and lead to inflammation and purulent processes.

To prevent this from happening, a curettage procedure is performed.

By the way, after a cesarean section, the placenta always has to be removed mechanically.

How is the uterine cleansing procedure performed?

Curettage of the uterus is performed on a gynecological chair. In this case, the woman is under general anesthesia.

If the placenta does not pass immediately after birth, the doctor performs manual curettage: while the cervix is ​​still sufficiently dilated, it allows you to remove excess tissue and blood clots manually.

If the need for cleaning was discovered later during an ultrasound, they are used for curettage. special tools, which “scrape off” the endometrial mucosa.

Before the procedure, the genitals are treated with iodine solution and alcohol solution. Sterility plays a big role in cleaning because inner surface the uterus at this time is big wound susceptible to infection.

Postoperative period. How to behave and what not to do?

After the scraping procedure, the woman should pay attention to hygiene and treat the genitals with an antiseptic.

At this time, it is prohibited to use tampons and douching. You can't take it either hot bath, visit the baths - during recovery you will have to limit yourself to a shower.

Sexual intercourse until completion is also prohibited. recovery period.

After curettage, antibiotics, antispasmodics and drugs that promote the process of uterine contraction may be prescribed. While taking medications breastfeeding is usually prohibited, so milk will have to be expressed so as not to disrupt the lactation process.

For two weeks after cleansing, you should not lift heavy objects or subject your body to physical activity.

Complications after cleaning

If an infection is introduced during curettage, this can lead to endometritis - an inflammatory process.

When bleeding, a hematomera may develop - an accumulation of blood in the uterine cavity, which appears due to problems with its outflow. If a woman has problems with blood clotting, then on the contrary, heavy bleeding and loss of large volumes of blood.

Normally, there is some bleeding after the procedure, but it is small and gradually decreases. If you have no discharge or a lot of bright red blood, consult a doctor.

After the birth is over, the baby is born and the placenta comes out, the restoration of the body begins. The first process is the reduction of the uterus to its previous size. This organ has amazing properties, since when carrying a baby it increases significantly. The uterus after birth weighs within 1 kg, and by the end of the recovery period it weighs only 50 g.

However, the recovery process can be complicated by a number of pathologies that arise only after childbirth and cannot be foreseen before, and therefore cannot be prevented. For example, the neck may become deformed.

Only a doctor can notice the violation during examination. Normally, the outlines of the external pharynx should be round, but with pathology they take the form of a slit. In this case, the neck itself will not be cone-shaped, as expected, but cylindrical. This and other disorders can affect a woman's fertility and make subsequent pregnancies difficult.

How to contract the uterus as quickly as possible after childbirth?

In normal postpartum period the organ is completely cleared of placenta remnants and blood clots within 3 days. The activity of this process is evidenced by discharge - bloody in the first days and serous-sanguineous in the subsequent days.

The epithelium will completely recover after 3 weeks. The contraction process is accompanied by slight cramping pain. After repeated births this phenomenon may be more pronounced and in some cases the woman is prescribed painkillers.

The absence of contractions (atony) or their weak intensity (hypotonia) are pathological and dangerous to health.

The activity of contractions depends on several factors: the number of fetuses, the location of the placenta, complications during birth process, the weight of the child, the health status of the mother in labor.

Atony occurs in the case of bending, trauma of the birth canal, underdevelopment of the organ, inflammatory processes, the presence of fibroids, polyhydramnios, and blood clotting disorders.

To contract the uterus, your doctor may prescribe special drugs, which will stimulate this process - oxytocin or prostaglandins.

The impulse could be breast-feeding, so you should feed the baby at his first request. A woman should move more, even if she had a caesarean section. It is better to sleep and rest on your stomach. It is worth noting that emptying the bladder can affect the rate of contractions, so if there is no swelling, you need to drink more fluids and visit the toilet more often.

The danger of atony lies in the fact that the body cannot get rid of the remnants of the placenta and blood clots. If they remain, inflammation will occur. That's why necessary procedure, if the above methods do not help, there will be scraping or cleaning. If this procedure is not performed, a hysterectomy will be required in the future.

When is it necessary to clean?

Cleaning the uterus is carried out after childbirth if parts of the placenta remain in it or blood clots have accumulated. You can find the remains on the planned ultrasound examination which is carried out after childbirth.

Why doesn't the body cleanse itself? The reason is weak labor activity when the doctor had to manually separate the placenta or if the placenta is very tightly attached.

Cleaning is carried out both medicinally and operative method. It is a mandatory procedure for the above pathologies. If such an event is not carried out, complications will arise in the form of inflammatory process and endometritis.

If clots are detected in the uterus on an ultrasound after childbirth, the doctor prescribes curettage, which is performed under general anesthesia. The operation time is no more than 20 minutes.

The procedure, like any other intervention, may be accompanied by complications. Most often, hematometra occurs - a delay in the cavity of the blood organ caused by cervical spasm. If vaginal discharge quickly stops after curettage, then there is this complication. To relax the cervix and prevent hematometra, No-shpa is prescribed.

Women with bleeding disorders may experience uterine bleeding, but this is a fairly rare occurrence.

If bacteria enter the cavity during cleaning, endometritis occurs - inflammation of the mucous membrane.

What are the consequences of a bent uterus?

Bend of the uterus, or displacement, after childbirth occurs due to weakness of the pelvic muscles and decreased tone of the ligaments. These factors, in combination with complicated childbirth, provoke some deviation of the organ back. The movement is accompanied by a bend.

Such a violation provokes decreased activity genital organs, characterized pain syndrome and functional deviations in this area. The bend is eliminated using the complex special exercises which a woman can easily perform at home.

Myoma

This pathology, unfortunately, is one of the most common. It is characterized by the formation of benign tumors in the muscular layer of the organ.

If treatment is not started in a timely manner, there is a high risk of developing early and late complications after the birth of a child, or rather:

• Heavy postpartum bleeding;
• Placenta accreta;
• Low uterine tone;
• Excessively tight attachment of the placenta and its partial separation;
• The uterus does not have the ability to restore its previous size;
• Infection of the organ cavity.

Polyps

Distinctive feature of this disease is difficult to diagnose because initial stage falls on postpartum hemorrhage, characteristic of this period. The main reason polyps are considered to have a history of abortion or curettage. A placental polyp can only be detected using ultrasound.

A woman needs hospitalization and a curettage procedure after delivery, when the remnants of the placenta and blood clots are removed. IN rehabilitation period she should take antianemic and antibacterial agents.

Removal operation

Hysterectomy - surgery to remove the uterus is performed for indications that include:

• Enometriosis, inability to stop uterine bleeding;
• Uterine prolapse due to pelvic floor rupture;
• After displacement, the reproductive organ disrupts the functions of the gallbladder.

Inflammation

Reasons for development pathological process quite a lot: cesarean section, prolonged labor, placenta previa, lack or non-compliance with hygienic/sanitary standards, etc. Symptoms of the disease include increased body temperature, rapid pulse, pain and enlargement of the abdomen, fever, purulent discharge from the vagina.

If a woman is concerned about the above phenomena, she should not delay her visit to the doctor. Postpartum complications may occur even when the mother and child have already been discharged home.

To protect yourself from the development of pathology and prevent disruption of reproductive functions, you need to contact a specialist who can diagnose correct diagnosis and prescribe adequate treatment, or reassure the woman if no diseases are detected.