Postpartum abdominal pain or vaginal bloating
Introduction
Introduction Postpartum lower abdominal pain or vaginal bulge is a manifestation of uterine varus. Intrauterine uterus refers to the uterus at the bottom of the uterus, or even the lesion from the cervix, which is a rare and serious complication during childbirth. Most occur in the third stage of labor, the degree of uterus inversion is different, the light can only be expressed as postpartum lower abdominal pain or vaginal bulge, and severe cases can cause painful shock. The main cause of this symptom is due to improper treatment of the third stage of labor, in addition to pregnancy-induced hypertension, uterine factors, etc. can also induce the disease.
Cause
Cause
Most of the uterus is improperly treated due to the third stage of labor (about 50%), but its prerequisites must be the relaxation of the uterine wall and the expansion of the cervix. The factors that contribute to uterine inversion are:
1. The result of the midwife's strong attachment to the placenta umbilical cord at the bottom of the uterus. At this time, if the umbilical cord is tough and does not break from the placenta, uterine varus will occur when the uterus is squeezed.
2. During the umbilical cord is too short or entangled in the process of fetal delivery, excessive traction of the umbilical cord will also cause uterine inversion.
3. Congenital uterine dysplasia or maternal excessive debilitation, in the labor process due to cough or the second stage of labor forceful breath, abdominal pressure increased, it will also cause uterus varus.
4. Maternal standing delivery: due to the fetal weight on the placenta umbilical cord traction, causing uterus varus.
5. The use of magnesium sulfate in the pregnancy-induced hypertension causes the uterus to relax, which also promotes uterine inversion. It has been reported that an implanted placenta also promotes uterine inversion.
Examine
an examination
Related inspection
Colposcopy vaginal palpation abdominal flat vaginal gynecological routine examination abdominal perspective
(1) Abdominal examination: Acute uterine inversion of the abdomen usually does not reach the regular uterus contour, the uterus is obviously lower and wider, and the bottom of the uterus is cup-shaped or stepped. Chronic uterine inversion can only be manifested as a sign of peritonitis.
(2) vaginal examination: acute uterine vaginal bleeding is not the same. The placenta may or may not be peeled off, and the placenta is not easily removed. The placenta stripper can touch or see the soft ball stuffed with the birth canal or get out of the vaginal opening. Careful examination of the spherical circumference of the ball or the discovery of the fallopian tube opening can be clearly diagnosed. Chronic uterine inversion, in addition to the performance of acute uterine varus, there are chronic inflammation, inflammatory vaginal discharge, swelling of the surface of the tumor, bleeding, erosion and so on.
Diagnosis
Differential diagnosis
Postpartum abdominal pain: symptoms of abdominal pain after childbirth, medically known as "postpartum abdominal pain", also known as "children's pillow pain."
One side of the lower abdomen pain: should be considered for the side of the uterine attachment lesions such as ovarian cyst pedicle torsion.
Lower abdominal pain: refers to the feeling of pain and swelling. It is a characteristic of qi stagnation. Lower abdominal pain is common in menstrual menstruation and various digestive diseases.
Bilateral lower abdomen pain: is the clinical manifestation of pelvic inflammatory disease. Minimum standard: cervical pain or uterine tenderness or tenderness of the attachment. Additional criteria: body temperature over 38.3 ° C; cervical or vaginal mucus purulent discharge; vaginal secretions 0.9% nacl solution, see a large number of white blood cells; erythrocyte sedimentation rate increased; blood c-reactive protein increased; laboratory confirmed Cervical gonorrhea is positive for Neisseria or Chlamydia.
Lower abdomen pain: In daily life, women always encounter a lot of unspeakable discomfort, and lower abdominal pain is a more common one. Lower abdominal bulge is mainly related to pelvic congestion, and many of them can be classified as medically known as pelvic congestion syndrome.
