Puerperium

Question 1

Puerperium is the period bw ___ and return of ___ to nonpreg contours

takes apprx ___ wks

this means by 6wks, most changes of __ and __ and __ have resolved, body is back to __ state

Endometrial lining ___
Placental bed ___
Cervix ___, but never returns to ___ state as ___ is open

Vagina returns to ___ state
epithelim becomes ____

Perinuem __ goes down, tone can ___

Answer 1

delivery, uterus

6wks

preg, L/D, nonpreg

regenerates
involutes
reforms, nonpreg, external os

nonpreg stae, atrophic

swelling, return

Question 2

Vaginal bleeding after delivery (aka ___) can __

starts as ___, mainly __ for 1-3 days
composed of blood, frag of __ and __

then ___, mainly __, for 3-10 days
composed of __ and __ and __

then ___, mainly ___, for 10-14 days
composed of

Answer 2

lochia, continue

lochia rubra, red, decidua/mucus

lochia serosa, pink
blood, mucus, leuks

lochia alba, white
mucus

Question 3

Blood volume returns to nonpreg level by ___

CO inc in ___ and returns to late preg level by __ postpartum and normal by ___ wks

majority of changes in CV system by __ wks

Initial dec in __ due to blood loss
stabilized in __ days

Initial inc in __
inc in __ activity, eventually dec in ___ wks

All diameters/angles of respiratory system return to normal ___wks postpartum

Answer 3

10th day

hour after delivery, 2 days
2-6wks

6-8 wks

Hb
2-3

fibrinogen
fibrinolytic activity, dec in 1-4 wks

1-3wks

Question 4

Post partum depression

Sleep
Interest
Guilt
Energy
Conc
Appetite
Psychomotor
Suicide

sx

Answer 4

insomnia/hypersomnia
Dec interest/pleasure in activities
thoughts of worthlessness
low
poor
change
retardation/agitation
thoughts of death/suicide

Question 5

Post partum blues
Found in __ women

Sx
Depressed __
T
F

onset w/in __ after delivert

resolves w/in

RF
hx of ___
Complicated __ such as w ___/__ use, ___ outcome
__ during labor

tx w __ and __

Answer 5

majority

affect
tearfulness
fatigue

2-3 days

10 days

depression
delivery, NICU/Csection, adverse
Excessive pain

reassurance/surveillance

Question 6

Post partum depression

Sx
Depressed
W
D
Loss of 
A

onset w/in ___ mns after delivery
Can last for ___ or more

Tx group/indiv ____
meds such as ___

Answer 6

depressed affect
weight loss
difficult conc
energy
anx

1-3
year

therapy

SSRIs

Question 7

Post partum psychosis

Severe ___ w assc __

Sx
D
H
C
H/S

lasts __ wks
Tx w __ and ___
often requires ___ care/__ admittance

Answer 7

PPD, delusions

delusions
hallucinations
confusion
homocidal/suicidal ideation

4-6 wks
antipsych meds, therapy

emergency, inpt

Question 8

Tx of PPD
Meds but keep in mind __
Counsel w ___
F

Answer 8

Breast feeding
resources
follow up