OB Test 2:Postpartum Flashcards
Involution
Process of shrinking back to normal size
The increase in cell number is permanent but size will decrease
What is the post-partum period?
From birth until the mother returns to normal
6 weeks (40 days)
Involution: fundus level
After birth at 12 hours: below umbilicus
4weeks: level of umbilicus
Involution: subinvolution
Put pt at risk for hemorrhage from retained tissue or uterus infection
Involution: after pains
Pt perceive it as cramps. Increased in multigravida, breast feeding or if uterus is over distended
Involution: placental site
Heals by exfoliation, from bottom up, no scar
Lochia colors
Rubra: red clots, 1st couple days
Serosa: pink, serous discharge, upto 2-6 weeks
Alba: white, creamy, 1-2 weeks
Lochia odor
Non-foul
Earthy
Lochia amount
C-section: scant amount until Pitosin wears off
Coninuous bright red is abnormal
Could have uterus atony (not contracted) or laceration
Cervix conditions
- friable: easy to bleed
- may have small lacerations
- return to normal 1 week after birth
- cervix has no longer a circle but a sideways slip
Vagina conditions
- less rugae
- not producing mucous
- if breasted then ovulation is delayed
Perineum
REEDA (red, edema, ecumosis, drainage, approximation)
Episiotomy
Lacerations
Hematoma: may be pushed outside & shrink quickly
Hemorroids: bleeding under skin, painful, severe blood loss
Postpartum hormones
Placenta: decrease hCS (hPL)
Decrease estrogen
decrease progesterone
Pituitary: increase prolactin
Ovarian menstraul cycle: 10-12 weeksAbdomen
Decrease muscle tone (2-3 months for tone back)
Diastasis recti abdominis
Renal system and fluid balance
Proteinuria Diaphoresis and Diuresis - characteristic - void enormous amounts within 12 hours of delivery - void upto 3,000cc per day - elevated BUN Bladder distention Kidney function returns to normal after 1 month
