|
Puerperium
Description
Puerperium is the period from termination of pregnancy to the involution of the uterus, traditionally 6 weeks.
Involution of reproductive organ
Uterus:
Just after birth: Slightly below umbilicus, weighs about 1000 gm.
Day 2: Uterus begins to shrink.
2 weeks: Uterus descends into pelvic cavity; weighs 300 gm.
6 weeks: Uterus returns to normal nonpregnant state; weighs 50-70 gm.
Placental site involution takes 6 weeks.
Abdominal wall:
Because of rupture of elastic fibers in the skin during pregnancy, abdominal walls remains\ soft and flabby after childbirth.
Exercise helps speed recovery of abdominal walls.
Urinary tract:
After birth: over-distention and incomplete emptying occurs.
Complete recovery takes 2-8 weeks.
About 7% of women develop stress incontinence after delivery; Kegel exercises are helpful.
Care: immediately after childbirth
Bleeding: Vaginal bleeding should be monitored closely.
Care of perineum:
Mother should be advised to clean the perineum from front to back after bowel movements.
Hot sitz bath can reduce discomfort of perineal area and enhance recovery.
Early ambulation:
Women can get out of bed several hours after childbirth: An attendant should monitor the first ambulation.
Early ambulation reduces bladder complications and constipation.
Care: puerperal period
After pains:
Uterine contractions after birth cause pain.
After pains are more common in multiparous women and when the baby suckles.
After pains decrease after 3 days after childbirth.
Lochia:
Lochia is red, due to mixture of blood and tissue, for the first few days.
After 3-4 days, lochia gradually becomes pale in color.
After 10 days lochia, becomes yellowish-white in color.
Temperature:
Physiologic " milk fever" can occur on 3rd or 4th day.
Any fever after childbirth should be monitored. It can indicate an infection.
Bleeding:
Any bleeding exceeding 2 times the amount of menstrual blood should be monitored.
Weight loss:
Initially after birth, 10-13 lbs is lost due to uterine evacuation and 4.5-6.5 lbs is lost due to diuresis.
Most women approach their prepregnancy weight within 6 months.
|
|
|
|
|
|
|