Normal and abnormal Puerperium Liu wei Department of ob Gy Ren Ji hospital
Normal and Abnormal Puerperium Liu Wei Department of Ob & Gy Ren Ji hospital
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 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 Puerperium The relevant anatomy and physiology in the puerperium 1. Reproductive organs 1) Uterus v1000g→50-100g v The endometrial lining rapidly regenerates (16 days) The placental site undergoes a series of changes 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 Puerperium 2) Cervix it never returns to the nulliparous state. v the external os is closed to the extent that a finger could not be easily introduced 3) Vagina v shrinks to a nonpregnant state resolution of the increased vascularity and edema occurs by 3 week the vaginal epithelium appears atrophic on smear. 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 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
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