Puerperium

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  • Created by: libsd
  • Created on: 23-01-19 18:57
What is the puerperium
The reversing of physiological changes that occured in pregnancy which ceases when reproductive organs have returned to their pre-gravid state which can take approximately 6-8weeks
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What happens to the uterus
It contracts with the contractions being at the strongest in the first 12-24hrs
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What happens to the blood vessels in the uterus
They constrict causing ischaemia
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What is the disposal of redundant tissue called
Autolysis
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What happens during autolysis
Intracellular proteins are broken down by proteolytic and hydrolytic enzymes, thromed vessels are broken down, phagocytosis by macrophages
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When does regeneration of the endometrium occur
2-3 days postpartum
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What happens during endometrial regeneration
The spongy layer is invaded with lymphocytes
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What happens to the placental site
After delivery it is a raised rough area of thrombosed sinusoids, lumen of vessels are invaded by firoblasts, exfoliation heals the site, endometrial glands in the decidua basalis grow up, endometrial tissue from the margins grow simultaneously
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What is the cervix like post delivery
Thin, bluish, odematous with multiple lacerations, 3-4cm dilated
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What changes happen to the cervix
12-18hrs it shortens and becomes firmer, one week it will admit a fingertip, small transverse slit at four weeks
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What is the vagina like post delivery
Odematous with no rugae
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What is the vagina like by 4 weeks
Rugae have reappeared and odema and vascualrity reduced
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What are remnants of the hymen known as
Carnuclae myritiformes
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What might decreased lubrication cuase
Dyspareunia
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What is lochia
Waste tissue passed through the vagina as the uterus involutes
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What is the lochia like at 2-4days
Lochia rubra is dark red/ brown and contains blood pieces of decidua, chorion, vernix, lanugo and meconium
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What is lochia serosa and when does it occur
Occurs till day 10 and contains some blood, wound exudate, erythrocytes, leucocytes, cervical mucosa, shreds of degenerating decidua
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What is the lochia called at 3-4 weeks
Lochia alba that contains leucocytes, mucous, bacteria and epithelial cells
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How much lochia is produced
330ml
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How much lochia is lost by c-section
121ml by emergency, 112ml by elective
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How much lochia is lost by forceps
238ml
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How much lochia is lost by a normal vaginal delivery
197ml
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How long does loss last
39days
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When does fertility return
After 8-10 weeks if not breastfeeding
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What will inhibit fertility and why
High prolactin levels but timing is variable and dependent on duration and frequency of sucking
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When does ovulation occur
Prior to first menstural cycle
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Other cards in this set

Card 2

Front

What happens to the uterus

Back

It contracts with the contractions being at the strongest in the first 12-24hrs

Card 3

Front

What happens to the blood vessels in the uterus

Back

Preview of the front of card 3

Card 4

Front

What is the disposal of redundant tissue called

Back

Preview of the front of card 4

Card 5

Front

What happens during autolysis

Back

Preview of the front of card 5
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