Postpartum Flashcards
What is puerperium period?
Period when uterus returns to its non-pregnant condition. It
begins immediately after parturition and lasts until another pregnancy occurs.
What is involution?
Process of reduction of the uterus to its non-pregnant size and state following birth of the offspring.
What is the lochia?
The normal uterine discharge of blood, tissue, and mucus from
the vagina after birth.
What is lactogenesis and lactation?
Synthesis, secretion and delivery of milk from the mammary gland.
When is the amount of postpartum discharge greatest?
During the first 48 hours after calving.
What changes occur in the appearance of the discharge by Day 4 postpartum?
The discharge changes to dark yellow or brown.
What does the discharge look like by Day 10 postpartum?
It changes to red or reddish-grey due to the presence of blood and sloughed uterine tissue.
What is normal vulvar discharge?
Fluid and cellular debris, particularly from the uterus.
What defines abnormal discharge? When is it common?
Discharge which continues well past 20 days post-partum, has an unpleasant odor and/or
contains purulent material (infection).
More common after difficult calving, may be an indicator of potentially serious problems.
What happens to lochia volume as time goes on
It decreases (almost completely by day 20 PP)
What does uterine involution depend on?
Process depends upon the extent of uterine damage,
the fitness of the uterus prior to parturition, and other factors (nutrition, disease, infection, age).
What is the time range for uterin involution
Time ranges from 2 to 8 weeks, with an average of 5 to 6 weeks.
What does uterine involution involve?
Process involves the dying and sloughing of the endometrium. Aided by uterine contractions and extensive tissue reorganization and re-growth.
What happens to uterine length and weight over time?
They decrease, almost back to normal by 20 days PP
What occurs in the first 24h after calving related to contractions?
- During first 24 h after calving, uterine contractions occur about once every 3 to 5 minutes and may last 1 min or more.
- Number decreases with time, barely noticeable 3-5 days post-partum.
What occurs up to 15 days PP?
Up to 15 days post-partum, constriction of blood vessels leads to disintegration, dissolution, and sloughing of the hypertrophied endometrium.
When does the regenerative phase begin?
almost immediately in
intercaruncular areas.
When is more time required for re-growth of maternal caruncles
More time is required for the reduction and re-growth
of the maternal caruncles, especially those of the
previously pregnant horn.
How long does it take for the lining cells to form in the areas between the caruncles postpartum?
Within 8 days.
How long may complete restoration of deeper layers, such as the mucosa and gland cells, take after calving?
It may take up to 35 days.
When does the caruncular surface begin to slough postpartum?
By day 15 to 20 postpartum.
What happens to the caruncles after they slough?
They are covered with a new lining that grows in from the periphery.
When does most restoration of the uterine lining occur postpartum?
By 20 to 30 days after calving.
How long does it take for the uterine caruncles to regress to normal size?
Regression to normal size will not be complete until 50 to 60 days postpartum.
How does difficult calving affect the restoration process?
extends the time and extent of the entire restoration process.
what can you expect to see on the bovine cervix 1 day PP?
-brownish colorremnant
of cervical seal of
pregnancy
-Hemorrhages are evident
due to abrasive trauma
what can you expect to see on the bovine uterus 1 day PP?
-Contains large caruncles
-Some caruncles undergoing necrosis
-Enlarged image shows an
incised caruncle. Entire layer of the tissue will be sloughed off into the uterine lumen.
what can you expect to see on the bovine cervix 4 day PP?
Lochia expelled from cervix
and accumulated in the ventral
region of the cranial vagina
what can you expect to see on the bovine uterus 4 day PP?
Placental tissue is sloughed off along with blood forming
lochia
what can you expect to see on the bovine cervix 10 day PP?
-Diameter of the cervix is reduced
-Evidence of hemorrhages are still present at the vaginal floor
what can you expect to see on the bovine uterus 10 day PP?
-significant decrease in the size
of caruncles compared with Days 1 and 4 post-partum
what can you expect to see on the bovine cervix 15 day PP?
Strands of mucus (M) indicate that this cow is entering her first “follicular phase” after
parturition
what can you expect to see on the bovine uterus 15 day PP?
Caruncles are smaller and is covered with mucus
what can you expect to see on the bovine cervix 20 day PP?
Vagina and cervix are free of hemorrhages
what can you expect to see on the bovine uterus 20 day PP?
Caruncles regressed, endometrial folds reaching the size of those seen in the nonpregnant uterus
What conditions predispose the uterus to infections? (3)
retained fetal membranes, dystocia, delay in lochial espulsion
What type of growth occurs between birth and puberty?
Isometric growth.
What type of growth occurs between puberty and pregnancy?
Allometric growth.
What characterizes isometric growth?
Growth in which body parts increase in size at the same rate.
What characterizes allometric growth?
Growth in which different parts of the body grow at different rates, often leading to changes in body proportions.
What hormones are involved in duct development?
Estrogen, prolactin, growth hormone
What hormonal influence causes the mammary ducts to branch and increase in diameter during the first estrous cycles after puberty?
Estrogens.
What occurs under the influence of progesterone during the luteal phase of the estrous cycle?
The branches of the mammary ducts begin forming the alveoli.
What do alveoli in the mammary gland represent?
The functional secretory units of the mammary gland.
What are the 5 steps of milk ejection?
- Suckling stimulates sensory
neurons in the mammary gland. - Impulses travel through
afferent neurons to the
hypothalamus. - PVN stimulates pituitary to
release oxytocin. - Oxytocin enters the blood and is delivered to the mammary gland. Target of oxytocin is myoepithelial cells of the alveolus.
- Contraction of myoepithelial
cells causes squeezing of colostrum/milk from alveolus
into small and large ducts that
finally goes to milk cistern.
What occurs to the secretory cells in the mammary gland as pressure builds up?
The secretory cells become less functional.
What is mammary involution?
The process that allows the mammary gland to recover and develop new secretory tissue for subsequent lactation
What do the first postpartum estrus and ovulation signify?
They mark the return of cyclic ovarian activity.
How many cows do not express behavioral estrus with the first postpartum ovulation?
50%
What percentage of dairy cows have ovulated by 25 days postpartum?
75%
What percentage of dairy cows have ovulated by 50 days postpartum?
95%
What factors influence the return of ovarian activity postpartum? (7)
Energy balance, genetic potential, state of the uterus, suckling or milking frequency, age at calving, housing, and season (temperature, food availability).
What effect does keeping the cow and calf together (beef) have on cyclicity?
It delays the return to cyclicity, likely due to regular, repeated suckling affecting GnRH release.
What condition is associated with low body fat levels in cows?
Anestrus
What hormone is produced in adipocytes and affects GnRH release? (cows)
Leptin
How does leptin influence the reproductive system?
It modifies appetite and feedback to the hypothalamus, impacting GnRH release (nutritional anestrus).
What should be done if the placenta is not expelled shortly after birth in mares?
It should be treated or removed within hours to prevent sepsis.
What types of trauma are more common in mares compared to other species?
Trauma to the uterus, cervix, vagina, urethra, and rectum (recto/vaginal tears).
What can postpartum colic in mares result from?
Rapid changes in the position and function of the viscera during and after parturition.
What is an important postpartum consideration in mares that occurs several days after parturition?
Foal heat
What is subinvolution of placental sites in canines?
It’s a condition where placental sites do not involute properly, leading to persistent discharge.
In which group of females is subinvolution of placental sites more commonly observed? (dogs)
Young females
What is the typical timeframe for postpartum discharge in canines?
Normal discharge should resolve within six weeks.
