Adaptations
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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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