Physiology of the Puerperium Flashcards
What 3 things aid the involution of the uterus?
- Contractions
- Autolysis
- Epithelial regeneration and proliferation
What is ischaemia?
Tissue death caused by the constriction of uterine blood vessels following delivery
What is autolysis?
The use of proteolytic enzymes to ingest redundant ischaemic muscle fibres
What are the 3 types of lochia?
- Lochia Rubra
- Lochia Serosa
- Lochia Alba
Describe lochia rubra
- Red in colour
- Fresh blood from placental site
- Lasts 3-4 days
Who may experience less lochia?
Women who had a CS
Describe lochia serosa
- Pink in colour
- Lasts 10-14 days
- May have slightly sweet odour
Describe lochia alba
- Cream/white in colour
- Lasts 4-8 weeks
What may happen around day 7?
A fresh loss of red blood due to the fibrin mesh being shed from the placental site
What hormonal changes occur following delivery?
- Decreased oestrogen and progesterone
- Increased prolactin and oxytocin
- FSH and LH will eventually increase to recommence ovulation
What is lactational amennorhoea?
The absence of a period due to breastfeeding - this does not mean they cannot get pregnant
Why is urinary output decreased in the first 48 hours?
- Decreased oestrogen levels reduces the plasma volume of the blood so less water is absorbed
- Decreased progesterone levels causes unbalanced aldosterone levels
What should be done postnatally to check for urine retention?
Women must give a sample of at least 250ml of urine within 6 hours of delivery
What should be done if not enough urine is produced after 6 hours?
- Ask them to drink lots of water and try again when desperate
- If still not enough, bladder scan +/- catheterise
Describe the levels of separated recti muscles
1cm = normal 2cm = no abdominal exercise for up to 12 weeks 3cm = refer to physio
