Puerperium and its Disorders Flashcards
What is the definition of the puerperium?
The period from the delivery of the placenta to the first 6 weeks after delivery.
How long does it take for the uterus to return to its non-pregnant state?
It takes approximately 6 weeks.
What is the weight change in the uterus from term pregnancy to 6 weeks postpartum?
From 1000g at term to 50-100g at 6 weeks postpartum.
What happens to the cervix during the puerperium?
The cervix never returns to its nulliparous state; the external os closes to the extent that a finger cannot be easily introduced.
How soon does ovulation occur postpartum in non-breastfeeding women?
As early as 27 days.
What are the three types of lochia, and how do they progress?
Lochia rubra (red), lochia serosa (brownish-red), and lochia alba (yellow).
What are the stages of lactation?
Mammogenesis, lactogenesis, galactopoiesis, and galactokinesis.
What triggers lactogenesis?
Delivery of the placenta triggers lactogenesis.
What happens to prolactin levels in non-breastfeeding women?
Prolactin levels decrease and return to normal within 2-3 weeks.
What cardiovascular changes occur during the puerperium?
Blood volume returns to non-pregnant levels by the 10th day; cardiac output normalizes by 2-6 weeks.
What are the routine postpartum care measures for vaginal delivery?
Includes ice application, routine perineal care, and warm sitz baths after 24 hours.
How is postpartum pain managed after a caesarean delivery?
Pain is managed with ice application and systemic pain medications.
When can sexual intercourse typically resume postpartum?
Typically resumes after about 3 weeks when the woman is physically and emotionally ready.
What are the key components of general management during puerperium?
Monitoring for PPH, uterine involution, lactation establishment, and early ambulation.
Name the two types of postpartum hemorrhage (PPH).
Primary and secondary postpartum hemorrhage.
What are the common causes of secondary PPH?
Infection, retained placental bits, and uterine subinvolution.
Define puerperal fever.
Oral temperature of ≥38°C recorded twice in the first 10 days postpartum (excluding the first 24 hours).
What are the risk factors for puerperal sepsis?
Anaemia, malnutrition, prolonged labour, and poor hygiene.
List the immediate complications of puerperal sepsis.
Septicaemia, septic shock, DIC, pulmonary embolism, kidney failure, and death.
What is the commonest puerperal psychiatric disorder?
Puerperal blues.
What are the management options for breast engorgement?
Firm breast support and analgesics.
What is the treatment for cracked nipples?
Use of nipple creams and ensuring proper breastfeeding techniques.
What are the risk factors for venous thromboembolism (VTE) during puerperium?
Increased maternal age, obesity, anemia, dehydration, and reduced mobility.
Name the types of puerperal psychiatric disorders.
Puerperal blues, depression, and psychosis.
What are the preventive measures for puerperal sepsis?
Good antenatal, intrapartum, and postnatal care.
How is urinary retention managed postpartum?
Managed with catheterization.
What are the signs of obstetric palsies?
Severe neuralgia and foot drop.
What is the weight of the uterus immediately postpartum?
Approximately 1000g.
How long does lochia discharge typically last?
Averages about 5 weeks.
What is the first type of milk produced after delivery?
Colostrum.
What changes occur in the hematological system during puerperium?
Hemoglobin concentration increases, and clotting factors are elevated.
What is the management of perineal swelling postpartum?
Ice application and warm sitz baths.
Name the five “Ws” causes of puerperal fever.
water, wind, walking, wound, wonder drugs.
How is postpartum anemia managed?
Managed with iron therapy and blood transfusions if necessary.
Define secondary postpartum hemorrhage.
Hemorrhage occurring after 24 hours to 12 weeks postpartum.
What are the differential diagnoses for puerperal sepsis?
Endometritis, salpingitis, pelvic cellulitis, pelvic thrombophlebitis, and infected episiotomy.
What is the commonest cause of puerperal fever in Nigeria?
Malaria.
What are the stages of uterine involution?
Palpable fundus near the umbilicus postpartum, reduction in size over 6 weeks.
What is the significance of prolactin during lactation?
Prolactin helps in milk production.
How is postpartum fever treated within the first 24 hours?
Treated with antipyretics and hydration.
What is the role of Anti-D immunoglobulin during puerperium?
Prevents Rh sensitization in Rhesus-negative mothers.
How much additional caloric intake is recommended for lactating mothers?
300 additional calories per day.
How long after delivery does cardiac output normalize?
By 2-6 weeks postpartum.
What exercises are recommended during puerperium?
Pelvic floor, abdominal tightening, foot, and leg exercises.
What is the commonest presenting feature of obstetric palsies?
Foot drop.
What are the symptoms of pelvic thrombophlebitis?
Pain, swelling, and tenderness in the pelvic region.
Name the curative measures for puerperal sepsis.
Use of antibiotics and wound care.
What are the late complications of puerperal sepsis?
Menstrual problems, chronic pelvic pain, and infertility.
How is postpartum fatigue managed?
Ensuring adequate sleep and hydration.
What is the role of early ambulation during puerperium?
Prevents venous thromboembolism (VTE) and promotes recovery.
