Puerperium Flashcards
When do you consider puerperium
Between 4 and 6 weeks
What is seen in the 3rd week of puerperium in the reproductive tract
Ruggae begin to reappear
Myrtiform curuncles
When does myometrial involution start
2 days after delivery
Uterus tends to remain tonically contracted
Primoparas
Contracts vigorously at intervals and gives rise to afterpains
Multiparas
Discharge First few days after delivery
Lochia rubra
Discharge after 3 or 4 days and becomes progressively pale
Lochia serosa
10th day of the discharge and admixture of leukocytes and reduced fluid content assumes a white or yellowish white color
Lochia alba
What layer involves the separation of the placenta and membrane
Spongy layer
What layer is necrotic ans what is the new endometrium
Superficial - necrotic
Basal - new endometrium
When is the endometrium fully restored
16th day onwards
Seen in almost half of postpartum women between 5 and 15 days
Acute salpingitis
When is the complete extrusion of the placental site seen
6 weeks
What causes an arrest of retardation of involution
Infection
Retained placental fragments
Incompletely remodeled uteroplacental arteries
What is the management of subinvolution
Ergonovine
Methylergonovie
Antiobotics for infection
When is late postpartum hemorrhage seen
24hrs to 12 weeks after delivery
Most common cause of late postpartum hemorrhage
Placental polyp
Treatment of late postpartum hemorrhage for a stable patient; empty cavity
Oxytoxin
Ergonovine
Methylergonovine
Prostaglandins
Treatment of late postpartum hemorrhage for large clots
Suction curettage
When does the urinary tract change to prepregnant state
2 to 8 weeks
What is the reason why the abdominal wall remains soft and flaccid
Rupture of elastic fibers in the skin
Marked separation of the rectus abdominis miscles
Diastasis recti
Cardiac output changes
elevated for 24 to 48hrs post partum
Declines by 10days
Weight loss through diureses
2 to 3kg
