What Is Meant by Uterine Involution?
The process through which a pregnant woman's uterus (womb) reverts to its pre-pregnancy state is known as uterus involution. During pregnancy, the uterus goes through significant changes. For example, the uterus expands to times its normal size, its blood vessels widen, and its lining becomes thicker. These modifications turn the uterus into an area where the developing fetus can find nourishment and safety. The uterus returns to its pre-pregnancy state after women no longer require these modifications to maintain the pregnancy.
Uterine involution is a major post-pregnancy alteration that allows women to restore some comfort and fertility. During involution, the uterus shrinks, reducing the weight that the body has carried during pregnancy. Involution is additionally required for the onset of menstruation. Uterus undergoes modifications that make it possible for a woman to become pregnant again rather than sustaining a fetus.
When Does Uterine Involution Begin?
The placenta is the bodily structure that enables the mother, or gestational parent, to provide nutrition to the fetus. It is affixed to the uterus throughout pregnancy. The placenta is delivered within a few hours of the baby's birth. As soon as the placenta is delivered, involution starts.
What Is the Process of Uterine Involution?
The uterus recovers to its pre-pregnancy state and approximate size during uterine involution. The uterus contracts to deliver the placenta after the obstetrician delivers the baby. The blood vessels are compressed due to the uterine muscular wall contracting and relaxing repeatedly. The region where the placenta was originally linked to the uterus bears constricted blood arteries to prevent excessive blood loss (postpartum hemorrhage). The uterus will continue to shrink and constrict during the following hours and days. Each day, it loses weight and takes up less room in the pelvic cavity. The endometrium (lining of the uterus) also regenerates or grows back.
Changes in Uterus Weight- Uteruses typically lose weight during the same period of time. Nevertheless, a woman's uterus' size and weight before becoming pregnant rely on a number of variables, including her previous childbearing history. People who have already given birth often have slightly bigger uteruses than women who have their first child.
Up to eight weeks after giving birth, a woman's uterus weighs about what is shown in the following breakdown-
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1000 grams immediately after delivery.
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500 grams after one week.
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300 grams after two weeks.
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100 grams after four weeks.
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60 grams after eight weeks.
Changes in Uterus Size- During involution, the uterus shrinks from around the size of a grapefruit, which occupies the entire pelvic cavity, to that of a pear.
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Following delivery, the top of the uterus will be located between the belly button and the pubic symphysis (a joint in the pelvic bone).
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Within 12 hours, the uterus' top rises till it is directly below the belly button.
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Every day, the uterus' top decelerates by 1 cm to 2 cm until it once again lies between the belly button and pelvic bone (within about a week).
What Are the Signs and Symptoms of Uterine Involution?
In the weeks after giving birth, the woman may feel discomfort from uterine contractions known as afterpains and see a discharge known as lochia. Both of these uterine involution symptoms are normal.
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Postpartum Cramps (Afterpains)- A woman may feel postpartum discomfort for a few days, particularly if this is not her first child. She can feel like she has period cramps or moderate labor pains as her uterus keeps contracting. When breastfeeding an infant, the pain frequently gets worse. Afterpains are usually considerably less severe and easier to handle by the third day following birth.
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Lochia- Following childbirth, lochia, or vaginal discharge, is expected. Materials from the uterus, such as blood cells, germs, and uterine lining fragments, which the body sheds after childbirth, make up lochia. Lochia may have a stale or musty odor comparable to a menstruation odor.
As the woman moves farther from the delivery date, it will look different.
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Day One to Day Three- Dark red discharge and a few tiny blood clots (not larger than a plum).
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Day Four to Day Ten- Discharge that is more watery and pinkish-brownish in color.
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Day 10 to Day 14- Discharge that is white or yellow.
After giving birth, a lochia discharge is typically between four and six weeks later. If a C-section instead of vaginal delivery delivers the baby, she will probably experience less lochia.
How Is Uterine Involution Diagnosed?
The doctor will assess whether the uterus is returning to its pre-pregnancy size during the postpartum appointment. An ultrasound may be requested to determine what is going on if the uterus is not shrinking as it should (a condition known as subinvolution). For example, an infection or leftover matter, such as placental pieces, can cause a uterus to take longer than usual to involute.
How to Manage Uterine Involution Symptoms?
A woman can take care of herself after the baby's delivery by following the following tips-
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Afterpains might be severe, especially when breastfeeding. The woman might experience severe cramping that lasts for around five minutes before fading gradually. The following measures can be taken to relieve this pain-
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Wrap a heating pad around the midsection.
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Go on a walk.
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Insert a pillow under the lower belly and lie on the stomach.
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Try the relaxation and breathing techniques that are recommended to minimize labor pains.
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Take the over-the-counter painkiller that the doctor has prescribed. (Acetaminophen may not be as effective as Ibuprofen).
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The lochia can be managed by wearing pads. Till six weeks after giving birth, or until the doctor says it is safe, avoid using tampons or inserting anything into the vagina.
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After giving birth, cramping and discharge are common, but excessive bleeding or infection symptoms call for medical treatment. If a woman during uterine involution experiences any of the following, she must consult a doctor immediately-
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A foul-smelling vaginal discharge.
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Passage of blood clots that are larger than a plum.
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Severe discomfort or cramping that persists more than three days after giving birth.
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A lot of blood loss (when the woman needs to change her pad more than once per hour).
Conclusion:
As the body prepares for pregnancy, changes happen quickly. Similar to this, the body returns to its pre-pregnancy state quickly. Just one week after giving birth, the uterus loses half of the weight it gained during pregnancy. In the interim, the expectant mother can experience unfavorable side effects like afterpain. She needs to keep in mind that light cramping a few days after delivery is beneficial. Her body is readjusting to its new normal, which it signifies. Painkillers, heating pads, and mild exercise can ease the discomfort as the uterus gets smaller.
