Postnatal Care

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Definition 6 weeks period following the child birth

during which the body tissues especially the pelvic organs revert back approximately to the pre pregnant state both anatomically and physiologically. 6 week interval between the birth of the new born and the return of reproductive organs to their normal nonpregnant state. period of six weeks which begins as soon as placenta is expelled

CHARECTERISTICS OF PUERPERIUM Reproductive organs return to the non pregnancy state. Other physiological changes of pregnancy are reversed. Lactation is stabilised. Reestablishment of menstruation. Foundation of relationship between parents and infant

is laid Mother recovers from stress of pregnancy & delivery Mother begins to assume responsibility for care and nurturing of the infant.

Physiology of the PuerperiumUterusAnatomic changes Physiological changes Contractions After pains Placental site Muscles& blood vessels Endometrial regeneration Lochia

Uterine ChangesChanges in the Cervix & Lower Uterine SegmentCervical opening contracts slowly and for a few days immediately after labor by the end of the 1st wk it has narrowed As the opening narrows the cervix thickens and a canal reforms. Bilateral depression at the site of lacerations remain as permanent changes that characterize the parous cervix

Peritoneum and Abdominal wallBroad & round ligaments : much more lax than nonpregnant : require considerable time to recover from stretching & loosening Abdominal wall : return to normal requires several weeks (aided by exercise) : usually resumes its prepregnancy state except for silvery striae

Physiology of the PuerperiumCardiovascular changes Cardiac output remains elevated for at least 48 hours postpartum

Changes of pregnancy reversed over three weeks Marked increase stroke volume immediately post partum 500-1000ml blood loss in normal delivery leukocytosis and thrombocytosis occur during and after labor

Hormones hPL Estrogen Progesterone FSH LH Prolactin

Change decreases decreases decreases decreases decreases decreases

Lowest level

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