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Post partum
Adaptations
| Question | Answer |
|---|---|
| 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
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