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Post partum

Adaptations

QuestionAnswer
Puerperium period after placenta delivery and lasts 6 weeks
Post partum period lasts up to 12 months after delivery
Uterus returns to normal size through involution- using 3 retorgressive processes: contraction of muscle fibers, catabolism and regeneration of uterine epithelium
Uterine descends umbilicus level at a rate of 1 cmper day
10 days post partum fundus is descended into the true pelvis
subinvolution results due to retained placenta or infection
lochia vaginal discharge after birth - superficial layer of the decidua bnasalis becomes necrotic and sloughed off
lochia present 3 weeks afer childbirth but can continue for 6 weeks
lochia rubra deep-red mixture of mucus, tissue debris and blood that occurs first 3-4 days after birth
lochia serosa pinkish brown and expelled 3-10 days postpartum. Contains leukocytes, decidual tissue and red blood cells
lochia alba creamy, white.10-14 days but can last 3-6 weeks postpartum
afterpains uterine contractions;caused by repeated stretching of the uterine muscle - more common with multiparous and breast feeding women
cervix returns to normal 6 weeks post partum
cervical os closes and returns to nomral by 2 weeks
external os widens and never appears the same, no longer shaped like a circle, but is"fish m outh"
vagina when estrogen resumes, mucosa thickens and ruggae returns in 3 weeks
perneum edematous and bruised for 1-2 days post partum;Kegel exercises used to improve pelvic floor tone and strengthen the perineal muscles and promot healing
heart cardiac output high post partum; normal blood volume within 4 weeks
hematocrit low levels is not an expected finding so decrease levels may indicate hemorrhage
urinary system complications may occur due to perineal lacerations, generalized swelling, hematomas, decreased bladder tone due to anesthesia
uterine atony urinary retention due to loss of tone can lead to hemorrhage
gastrointestinal system decreased bowel tone and sluggish bowels for several days
Integumentary System estrogen and progesterone levels decrease, darkened pigment on the abdomen (linea nigra) , face (melasma) and nipples fade
striae gravidarim stretch marks
estrogen lowest level a week after birth; continue to be low until breast feeding frequency decreases
lactation secretion of milk by the breast; progesterone, estrogen, prolactin and oxytocin
breast milk appears 4-5 days after childbirth
breast crawl newborn instinct to intiate breast feeding immediately after childbirth
ovulation nonlacting woman menstruation occur 7-9 weeks after delivery;lactating women 3-18 months
estrogen, progesterone, prolactin, oxytocin 4 major hormones post partum period
Created by: N122-OB