Normal Puerperium
正常产褥
Key Words
? Puerperium 产褥期
? involution 复旧
? lactation 哺乳
? colostrum 初乳
? lochia 恶露
Ⅰ,Definition
? The puerperium is the time following labor
during which the pelvic organs return to
their prepragnant condition,It is about 6
weeks,although it may take much longer
for some of the organs(breast) to return
completely to normal,
Involution of the uterus
? It is the process which the uterus grandually
return into the nonpregnant state after
expulsion of the placenta.
Change of corpora uterus
? weight and size after delivery
uterine weight, 1kg
size,as the uterus of 20th-week pregnancy
about 1cm below the umbilicus
? ② one week later:
uterine weight, 0.5kg
size,12th-week of pregnancy to
be just palpable above the
symphysis pubica,
? ③ The height of the fundus diminishes daily
and it cannot normally be felt above the
pubis after the 10th day.
? ④ second week:
weight,300g
? nearly complete involution of the uterus is
about 6 weeks,weight about 50g,
Involution of the uterus
? 1 day
? 5days
? 7days
? (2) mechanism:
decrease of myometrial cell size
the total number of muscle cells does
not decrease.
? (3)prolonged involution,
① uterine infection
② retention of placental products
③ fibromyomata in the uterine wall
Regeneration of endometrium
? Decidua
? superficial layer,necrotic shed lochia
basal layer, glandular epithelium proliferates
forms a new covering for the
endometrim
Change of Cervix
? After delivery,soft,flabby
? 2~3 days later,admits two fingers
? end of the first week,outline and internal os are
closed.
? 4 weeks,the cervix is completely recovery
? nulliparous,rounded external os
? multiparous,transvers slit due to laceration
? at point of 3,9 o`clock
Breast-feeding
1,The advantages of breast-feeding
? (1)The most suitable natural food for the growth
of infants,beneficial for digestion and absorption.
? (2)contain massive immunological substance from
mother
? (3)economic,sanitary,suitable,temperature,
available at any time,
? (4)For mother, promote uterine involution
(5)enhance materno-infantal affection (6)the
(6)beneficial for avoiding pregnancy.
(7)including iron,sodium calcium phosphate
salt,zinc ect which is not only beneficial for
the growth and development of infant,but also
promote the maturation of immuno-system
Baby-loving-hospital
? (1)early sucking,begin within 30 min after baby
birth
(2)mother and baby live in the same room
They are together with 24 hrs,To be divided
<1h/day,Include bath and medical treatment.
? (3)pure breast-feed
the infant eat only maternal milk within 4~6
months after birth,
? (4) breast-feeding according to need
? Colostrum
① <7daays of the postpartum
② sticky,yellowish fluid.
Richin protein globulin and minerals
less sugar and fat
easy to digest
③ IgA→prevent diarrhea
Changeof other system
? 1.cardiovascular change
2~3w
① blood volume nonpregnancy
72h↑15~25% heart failure
② Ⅺ,fibro → 2~3w normally
③ WBC ↑ 15-30× 109/L,
2.return of menstruation and
ovulation
? (1)Breast-feed,ovulation, 4~6months
? (2)no-breast-feed:
menstrual,6~10w postpartum
ovulation,10 weeks
※ occasionally,a nursing mother will ovulate
and become pregnant
clinical manifestation
1.Temperature and pulse
? The temperature may rise to 37.9℃ in the
first 24 hours,but afterwards is should fall
to normal and remain so.
? Milk fever,Breast engagement in 3~4 days
after delivery.
? Pulse,first day↑ second day→normal
? 2.involution of the uterus
? 3.After-pains,1~2 days appear
2~3days↓
multiparous is more common
? 4.sweet,(puerperal sweet),1w↑
? 5.The lochia
? the lochia is vaginal discharge due to
sloughing of decidual tissue,mainly from
the placenta site
? the lochia consists of RBC,
WBC,shreds of decidua,
epithelial cell and bacteria.
? (1)lochia rubrua,red in color
first 3~4 days
? (2)lochia serosa,pink→serous
after 3~4 days,last for about 10
days
? (3)lochia alba,yellowish→white
2weeks
Summary
Key point
? 1,Definition
? 2,Involution of the uterus
? 3,Breast-feed
? 4,Lochia
正常产褥
Key Words
? Puerperium 产褥期
? involution 复旧
? lactation 哺乳
? colostrum 初乳
? lochia 恶露
Ⅰ,Definition
? The puerperium is the time following labor
during which the pelvic organs return to
their prepragnant condition,It is about 6
weeks,although it may take much longer
for some of the organs(breast) to return
completely to normal,
Involution of the uterus
? It is the process which the uterus grandually
return into the nonpregnant state after
expulsion of the placenta.
Change of corpora uterus
? weight and size after delivery
uterine weight, 1kg
size,as the uterus of 20th-week pregnancy
about 1cm below the umbilicus
? ② one week later:
uterine weight, 0.5kg
size,12th-week of pregnancy to
be just palpable above the
symphysis pubica,
? ③ The height of the fundus diminishes daily
and it cannot normally be felt above the
pubis after the 10th day.
? ④ second week:
weight,300g
? nearly complete involution of the uterus is
about 6 weeks,weight about 50g,
Involution of the uterus
? 1 day
? 5days
? 7days
? (2) mechanism:
decrease of myometrial cell size
the total number of muscle cells does
not decrease.
? (3)prolonged involution,
① uterine infection
② retention of placental products
③ fibromyomata in the uterine wall
Regeneration of endometrium
? Decidua
? superficial layer,necrotic shed lochia
basal layer, glandular epithelium proliferates
forms a new covering for the
endometrim
Change of Cervix
? After delivery,soft,flabby
? 2~3 days later,admits two fingers
? end of the first week,outline and internal os are
closed.
? 4 weeks,the cervix is completely recovery
? nulliparous,rounded external os
? multiparous,transvers slit due to laceration
? at point of 3,9 o`clock
Breast-feeding
1,The advantages of breast-feeding
? (1)The most suitable natural food for the growth
of infants,beneficial for digestion and absorption.
? (2)contain massive immunological substance from
mother
? (3)economic,sanitary,suitable,temperature,
available at any time,
? (4)For mother, promote uterine involution
(5)enhance materno-infantal affection (6)the
(6)beneficial for avoiding pregnancy.
(7)including iron,sodium calcium phosphate
salt,zinc ect which is not only beneficial for
the growth and development of infant,but also
promote the maturation of immuno-system
Baby-loving-hospital
? (1)early sucking,begin within 30 min after baby
birth
(2)mother and baby live in the same room
They are together with 24 hrs,To be divided
<1h/day,Include bath and medical treatment.
? (3)pure breast-feed
the infant eat only maternal milk within 4~6
months after birth,
? (4) breast-feeding according to need
? Colostrum
① <7daays of the postpartum
② sticky,yellowish fluid.
Richin protein globulin and minerals
less sugar and fat
easy to digest
③ IgA→prevent diarrhea
Changeof other system
? 1.cardiovascular change
2~3w
① blood volume nonpregnancy
72h↑15~25% heart failure
② Ⅺ,fibro → 2~3w normally
③ WBC ↑ 15-30× 109/L,
2.return of menstruation and
ovulation
? (1)Breast-feed,ovulation, 4~6months
? (2)no-breast-feed:
menstrual,6~10w postpartum
ovulation,10 weeks
※ occasionally,a nursing mother will ovulate
and become pregnant
clinical manifestation
1.Temperature and pulse
? The temperature may rise to 37.9℃ in the
first 24 hours,but afterwards is should fall
to normal and remain so.
? Milk fever,Breast engagement in 3~4 days
after delivery.
? Pulse,first day↑ second day→normal
? 2.involution of the uterus
? 3.After-pains,1~2 days appear
2~3days↓
multiparous is more common
? 4.sweet,(puerperal sweet),1w↑
? 5.The lochia
? the lochia is vaginal discharge due to
sloughing of decidual tissue,mainly from
the placenta site
? the lochia consists of RBC,
WBC,shreds of decidua,
epithelial cell and bacteria.
? (1)lochia rubrua,red in color
first 3~4 days
? (2)lochia serosa,pink→serous
after 3~4 days,last for about 10
days
? (3)lochia alba,yellowish→white
2weeks
Summary
Key point
? 1,Definition
? 2,Involution of the uterus
? 3,Breast-feed
? 4,Lochia
