Information about Puerperium

Post partum period begins after delivery towards when reproductive tract returns to normal non-pregnant state.
Involution is the time when uterus returns to non-pregnant state.

• weight of uterus reduced from 2 lbs to 2 oz
• endometrium regenerates
• fundus descends into pelvis; fundal height decreases about 1 cm per day; by 10th day post partumly, fundus cannot be palpated abdominally.

Other Events during Puerperium

1. Cervix and Vagina

• the muscles of cervix after a week regenerates
• external os remains wider
• internal os is closed after a week
• vaginal distention decreases
• vaginal rugae reappeared by third week
• lacerations or episiotomy suture line gradually heal

2. Ovarian function and Menstruation

• dependent on how pituitary functions
• menses returns within 8 weeks to non-breastfeeding women and 3-4 months for breastfeeding mothers
• breastfeeding mothers may experience amenorrhea
• woman may ovulate without menstruating

3. Breast

• continue to secrete colostrum
• breasts become distended with milk on third day
• engorgement 48-72 hours in non-breastfeeding clients

4. Urinary Tract

• urinary retention may be experienced as a result of loss of elasticity and tone and loss of sensation from drugs, trauma or loss of privacy
• diuresis will be experienced within first 12 hours after delivery
• kidney function returns to normal easily

5. Gastrointestinal

• client will feel extremely starve after delivery
• constipation is occurring due to loss of tone and perineal tenderness
• hemorrhoids are common but eventually subsides

6. Vascular System

• WBC increases during labor and delivery, as well as early post partum period; then return to normal after few days
• Hemoglobin and RBC decreased and return to normal value after a week
• elevated fibrinogen levels during first week postpartum and contribute to thrombophlebitis
• blood volume is back by third week

7. Vital Signs

• temperature may be elevated to 100.4 F (38 C) during first 24 hours after delivery without pathologic condition
• bradycardia is usual for a week about 50-70
• blood pressure must be unchanged
  

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