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Maternal-Infant health > chapter 20 postpartum physiology > Flashcards

chapter 20 postpartum physiology Flashcards

1
Q

The interval between birth and the return of the reproductive organs to their normal nonpregnant state is called the

A

postpartum period

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2
Q

The postpartum period is also called

A

puerperium or fourth trimester

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3
Q

The return of the uterus to a nonpregnant state after birth is called what

A

involution

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4
Q

when does the involution process begin?

A

immediately after expulsion of the placenta with contraction of the uterine smooth muscle

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5
Q

At the end of the third stage of labor, the uterus is in the _________ approximately ____ cm below the level of the umbilicus with the fundus resting on the ______ ______

A

-midline
-2
-sacral promontory

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6
Q

How much does the uterus weigh at the end of the third stage of labor?

A

approximately 1000 g

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7
Q

within 12 hours postpartum the fundus can rise to approximately what

A

1 cm above the umbilicus

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8
Q

By 24 hours postpartum the uterus is about the same size as it was when?

A

20 weeks gestation

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9
Q

the fundus decends ___ to ___ cm every 24 hours postpartum

A

1 to 2 cm

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10
Q

by the _____ postpartum day the fundus is normally located halfway between the umbilicus and the symphysis pubis

A

sixth

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11
Q

the uterus should not be palpable abdominally after ___ weeks and should have returned to its nonpregnant location by ____ weeks after birth

A

-two
-six

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12
Q

The uterus weighs how many times its prepregnancy weight at full term

A

11 times

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13
Q

the uterus weight involutes to approximately how much by 1 week after birth

A

500 grams

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14
Q

the uterus weight involutes to approximately how much by 2 weeks after birth

A

300 grams

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15
Q

by four weeks after birth the uterus weighs how much

A

100 grams

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16
Q

what is responsible for stimulating the massive growth of the uterus during pregnancy

A

increased estrogen and progesterone

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17
Q

an increase in the number of muscle cells

A

hyperplasia

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18
Q

an enlargement of the existing cells

A

hypertrophy

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19
Q

uterine growth results from both _______ and ______

A

hyperplasia and hypertrophy

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20
Q

the self-destruction of excess hypertrophied tissue

A

autolysis

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21
Q

afterbirth the decrease in progesterone and estrogen causes what

A

autolysis

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22
Q

what causes the slight increase in uterine size following each pregnancy?

A

additional cells laid down during pregnancy that do not autolysis

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23
Q

the failure of the uterus to return to a nonpregnant state due to ineffective uterine contractions

A

subinvolution

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24
Q

what are the most common causes of subinvolution

A

-retained placenta
-infection

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25
Q

postpartum hemostasis is achieved primarily by compression of _______ ______ _______ as the uterine muscle contracts rather than by _____ _____ and ______ ________

A

-intramyometrial blood vessels
-platelet aggregation and clot formation

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26
Q

this is released from the pituitary gland and strengthens and coordinates uterine contractions

A

oxytocin

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27
Q

oxytocin promotes ________

A

hemostasis

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28
Q

exogenous oxytocin is called

A

Pitocin

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29
Q

why is pitocin given postpartum

A

because uterine contractions can become uncoordinated and decrease

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30
Q

what can increase the release of oxytocin during the first few days postpartum

A

breastfeeding

31
Q

breast feeding postpartum releases oxytocin which promotes uterine contractions therefore decreases what

A

blood loss and risk for postpartum hemorrhage

32
Q

afterpains usually resolve in __ to __ days

A

3 to 7 days

33
Q

afterpains are more noticeable after births in which the uterus was _________

A

overdistended

34
Q

what two things usually intensify afterpains because both stimulate uterine contractions

A

-breastfeeding
-exogenous oxytocin

35
Q

immediately after the placenta and membranes are expelled, ______ ______ and _______ reduce the placental site to an irregular nodular and elevated area averaging 4-5 cm in diameter

A

vascular constriction and thromboses

36
Q

______ growth of the endometrium causes sloughing of necrotic tissue and prevents the scar formation characteristics of normal wound healing

A

upward

37
Q

the unique healing of the endometrium allows what

A

resumption of usual cycle changes and implantation and placentation in future pregnancies

38
Q

endometrial regeneration begins within ____ days afterbirth and is completed by the _____ week

A

-3 days
-third week

39
Q

Regeneration at the placental site is completed by the _____ week

A

sixth

40
Q

the characteristics of postbirth uterine discharge is known as what

A

lochia

41
Q

lochia correlates with what two things

A

-uterine involution
-changes in the endometrium

42
Q

how long do most women typically experience lochia

A

4 - 6 weeks

43
Q

for the first two hours after birth how much lochia is to be expected?

A

that of a heavy menstural period

44
Q

if a woman receives an oxytocin medication the flow of lochia is often _____ until the effects of the medication wear off

A

scant

45
Q

the amount of lochia after a c-section is less due to what

A

the surgeon suctions the blood and fluids from the uterus or wipes the lining before closing the incision

46
Q

the flow of lochia usually increases with what

A

ambulation and breastfeeding

47
Q

a gush of blood when a woman stands is typical because why

A

blood pools in the vagina when lying down

48
Q

persistence of lochia rubra in the postpartum period suggests continued bleeding as a result of what

A

retained fragments of the placenta or membranes

49
Q

it is not uncommon for a woman to experience a sudden but brief increase in bleeding 7-14 days postpartum when what occurs

A

sloughing of eschar over the placental site occurs

50
Q

if bleeding from sloughing of eschar over the placental site lasts longer than 1-2 hours the woman should be evaluated for what

A

possible retained placental fragments

51
Q

what percentage of women still have normal lochia serosa discharge at their 6 week postpartum exam

A

10-15

52
Q

the continued flow of lochia serosa or alba by 3-4 weeks after birth can indicate what

A

endometritis

53
Q

what other symptoms occur with endometritis besides lochia serosa or alba?

A

-fever
-pain
-abdominal tenderness

54
Q

lochia should smell like normal menstrual flow, if odor is present it can indicate what

A

infection

55
Q

bright red lochia is called

A

rubra

56
Q

pinkish-brown lochia is called

A

serosa

57
Q

whitish yellow lochia is called

A

alba

58
Q

how long is lochia rubra to be expected after birth

A

1-3 days

59
Q

how long is lochia serosa to be expected after birth

A

4-10 days

60
Q

how long is lochia alba to be expected after birth

A

10-14 days but can last 3-6 weeks

61
Q

what are the contents of lochia rubra

A

-blood from placental site
-trophoblastic tissue debris
-vernix
-lanugo
-meconium

62
Q

what are the contents of lochia serosa

A

-blood
-wound exudate
-RBCs
-WBCs
-trophoblastic tissue debris
-cervical mucus
-microorganisms

63
Q

what are the contents of lochia alba

A

-WBCs
-trophoblastic tissue debris

64
Q

two types of postpartum bleeding

A

lochial and nonlochial bleeding

65
Q

usually trickles from the vaginal opening and the steady flow is greater as the uterus contracts is what kind of bleeding

A

lochial bleeding

66
Q

bleeding from the source of a tear of the cervix or vagina

A

nonlochial bleeding

67
Q

the cervix is _____ immediately after birth

A

soft

68
Q

what changes occur to the cervix 12-18 hours after delivery

A

it shortens and becomes firmer

69
Q

how long after birth does the cervix shorten, become firm and regain its form?

A

2-3 days postpartum

70
Q

by day two or three postpartum the cervical dilation decreases to how many cm

A

2-3

71
Q

by 1 week postpartum the cervical dilation decreases to how many cm

A

1

72
Q

what happens to the external cervical os after delivery

A

it never returns to circular shape but looks like a slit often described as fish mouth

73
Q

________ delays the production of cervical and other estrogen-influenced mucus and affects mucosal characteristics

A

lactation

74
Q

page 419 ovaries section

A

-

Maternal-Infant health (1 decks)

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