PUERPERIUM. JI Canarie Joy A. Esguerra OB-GYNE UERMMMCI. Outline. Definition Clinical and Physiological Aspects Vagina and Vaginal Outlet Uterine Changes Urinary Tract Changes Peritoneum and Abdominal Wall Blood and Fluid Changes (Weight Loss) Breast Hospital Care Care at Home.
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JI Canarie Joy A. Esguerra
CLINICAL and PHYSIOLOGICAL ASPECTS OF THE PUERPERIUM
: total number of muscle cells does not decrease
→ individual cells decrease markedly in size
→ 3-4cm in diameter (end of 2nd week, )
→ ultimately undergo organization of thrombus
→ usually undergo necrosis with deposition of fibrin
→ form a placental polyp
→ overdistention, incomplete emptying, excessive residual urine
→ rapid bladder filling
→ urinary retention with bladder overdistention
: catheter should be left in place and the bladder drained for another day.
: remove the catheter & recheck the bladder.
→ constipation ↓
→ codeine, aspirin, acetaminophen every 3 hours
: any time after vaginal delivery
: as soon as abdominal soreness diminishes after cesareandelivery
: symptomatic puerperal pelvic thrombosis
is most commonly associated with uterine infection
: complaints of intense neuralgia or cramplikepains extending down one or both legs as soon as the fetalhead begins to descend the pelvis
within 72 hours of the birth of a D-positive infant
CARE AT HOME
* Breast feeding: cause a prolonged period of suppressed estrogenproduction with a resulting vaginal atrophy and dryness
: women can resume most activities (bathing, driving, household functions) by the time of discharge
: identify any abnormalities of later puerperium
: initiate contraceptive practice