NormalandAbnormalPuerperium
Normal and Abnormal Puerperium
NormalPuerperiumDefinition1. The time from the delivery of the placentathrough the first few weeks after the delivery.2. 6 weeks in duration3. By 6 weeks after delivery, most of the changesofpregnancy,laborand deliveryhaveresolved and the body has reverted to thenonpregnant state
Normal Puerperium • Definition 1. The time from the delivery of the placenta through the first few weeks after the delivery. 2. 6 weeks in duration. 3. By 6 weeks after delivery, most of the changes of pregnancy, labor, and delivery have resolved and the body has reverted to the nonpregnant state
Normal PuerperiumThe relevant anatomy and physiology in thepuerperiumReproductive organsUterus1000g→50-100gThe endometrial lining rapidly regenerates(16days)The placental site undergoes a series ofchanges in the postpartum period
Normal Puerperium • The relevant anatomy and physiology in the puerperium 1. Reproductive organs 1) Uterus ✓ 1000g → 50-100g ✓ The endometrial lining rapidly regenerates (16 days) ✓ The placental site undergoes a series of changes in the postpartum period
Normal Puerperium2)Cervixit never returns to the nulliparous statethe external os is closed to the extent that afinger could not be easily introduced3)Vaginashrinks to a nonpregnant stateresolution of the increased vascularity andedema occurs by3weeksthe vaginal epithelium appears atrophic onsmear. This is restored by weeks 6-10
Normal Puerperium 2) Cervix ✓ it never returns to the nulliparous state. ✓ the external os is closed to the extent that a finger could not be easily introduced. 3) Vagina ✓ shrinks to a nonpregnant state ✓ resolution of the increased vascularity and edema occurs by 3 weeks ✓ the vaginal epithelium appears atrophic on smear. This is restored by weeks 6-10
Normal PuerperiumPerineumswelling and engorgement are completelygone within 1-2 weeksthe muscle tone may or may not return tonormal, depending on the extent of injury5）Ovariesovulate as early as 27 days after delivery (notbreastfeed);12weeks (most);7-9weeks(mean).the suppression of ovulation due to theelevation inprolactin
Normal Puerperium 4) Perineum ✓ swelling and engorgement are completely gone within 1-2 weeks ✓ the muscle tone may or may not return to normal, depending on the extent of injury. 5) Ovaries ✓ ovulate as early as 27 days after delivery (not breastfeed ); 12 weeks (most); 7-9 weeks (mean). ✓ the suppression of ovulation due to the elevation in prolactin