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Adaptations

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