Module 5: Post Partum Conditions And Complications Flashcards
Puerperium
Period after placental delivery, lasting 6 weeks
Postpartum reproductive system adaptations
Uterus involution, cervix closure, vaginal thickening
Involution
Describes rapid reduction in size of uterus and its return to a condition similar to its non-pregnant status.
Lochia
Vaginal discharge after birth resulting from involution.
Avg amount 240-270ml.
Present for 3-6wks
3 phases of lochia
Lochia rubra: 3-4 days after birth. Deep red.
Lochia Serosa: 3-10 days post partum. Pinkish-brown
Lochia alba: 10-14 days post partum (can last 3-6wks). Creamy white or light brown.
Vaginal changes postpartum
Mucosa thickens and rugae return in approximately 3wks.
Returns to approximate prepregnant size in 6-8wks
Cardiovascular postpartum adaptations
Blood volume drops rapidly and returns to normal in 4wks.
CO high for first few days, returns to normal in 3mo
Postpartum urinary system adaptations
GFR and renal flow increase.
Urination impedance.
Causes of postpartum diuresis
IV fluids
Decreased antidiuretic effect of oxytocin
Pregnancy fluid retention
Decreasing aldosterone production
Postpartum respiratory adaptation
vT, mV, vC, FRC return to prepregnant values 1-3wk after birth
Reva Rubin’s 3 phases of psychological adaptation
Taking in phase: 24-48hrs postpartum
Taking hold phase: 2-3 days, lasting several weeks
Letting go phase
Postpartum blues
Occurs in up to 80%. Usually peaks at day 5 and resolves by day 10.
Postpartum depression
Changes in mood and behaviour do not go away on their own.
Gradual onset, evident in first 6wks
Postpartum psychosis
Rare. Risk of infanticide and suicide. Evident within first few days following delivery, progresses rapidly.
Postpartum hemorrhage
Blood loss >500ml (vaginal) or >1L (C-section)
Leading cause of maternal mortality
Described as primary (first 24hrs) or delayed (24hrs to 12wks).
