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    Perperium

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    Xo Yem
    The document summarizes the physiological changes that occur during the postpartum period. Key changes include involution of the uterus and vagina, production of breast milk, changes in menstruation and hormone levels, urinary incontinence, weight loss, and return of the circulatory and digestive systems to a non-pregnant state over 6 weeks. Nursing care focuses on monitoring vital signs, uterine contraction, lochia, fluid intake, pain relief, lactation support, rest, perineal hygiene, and psychological support.

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    Perperium

    Uploaded by

    Xo Yem
    442 views14 pages
    The document summarizes the physiological changes that occur during the postpartum period. Key changes include involution of the uterus and vagina, production of breast milk, changes in menstruation and hormone levels, urinary incontinence, weight loss, and return of the circulatory and digestive systems to a non-pregnant state over 6 weeks. Nursing care focuses on monitoring vital signs, uterine contraction, lochia, fluid intake, pain relief, lactation support, rest, perineal hygiene, and psychological support.

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    perperium

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    The document summarizes the physiological changes that occur during the postpartum period. Key changes include involution of the uterus and vagina, production of breast milk, changes in menstruation and hormone levels, urinary incontinence, weight loss, and return of the circulatory and digestive systems to a non-pregnant state over 6 weeks. Nursing care focuses on monitoring vital signs, uterine contraction, lochia, fluid intake, pain relief, lactation support, rest, perineal hygiene, and psychological support.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    442 views14 pages

    Perperium

    Uploaded by

    Xo Yem
    The document summarizes the physiological changes that occur during the postpartum period. Key changes include involution of the uterus and vagina, production of breast milk, changes in menstruation and hormone levels, urinary incontinence, weight loss, and return of the circulatory and digestive systems to a non-pregnant state over 6 weeks. Nursing care focuses on monitoring vital signs, uterine contraction, lochia, fluid intake, pain relief, lactation support, rest, perineal hygiene, and psychological support.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 14

    Physiological changes of post partum

    period
    • Puerperium it is a time of maternal
    physiological and psychological changes that
    are retrogressive .
    • Involution of the uterus and vagina, producing
    of milk and reverse of menstruation.
    • Puerperium refers to the 6th week post
    delivery
    Reproductive system changes
    • Involution is a process where by the
    reproductive organ return to non pregnant stat.
    • The uterus-contraction
    • Immediately after delivery the uterus palpate
    between the umbilicus and the symphysis pubis
    for few minutes.
    • After 1hr the uterus rise to the level of
    umbilicus
    The uterus
    • The uterus involutes 1finger breadth below
    umbilicus each day .
    • 10 days the uterus will with draw into the
    pelvis and complete the involution at 6th.
    • Bf will initiate involution.
    • Full bladder delay involution and shift the
    uterus to one side
    The uterus
    • Uterus wt before 1000 g
    • After delivery 500gm.
    • After 6th week 50gm
    • The contraction of the uterus cause abdominal
    pain and cramping called after pains
    lochia
    • Blood consisting fragments of decidua, WBC,
    mucous and some bacteria.
    • Three kind of lochia.
    • Lochia rubra blood with small particle of decidua
    and mucous ,last for 3days.
    • Lochia serosa blood with cast tissue and
    leukocytes, pink to brown 3-10 days.
    • Lochia alba colorless discharge or white present
    until the 3rd week after birth
    The cervix
    • The cervix didn’t return to pre pregnant stat .
    • The internal os close but the external .
    • os remain slightly open.
    • The vagina:
    • After birth the vagina is soft with few rugae ,
    become flat, take 6th week post partum to
    involute .
    • Kegal exercise is beneficial to strength the vagina
    The perineum
    • The perineum:
    • The labia majora and minora remain atrophic
    and soft , didn’t return to pre pregnant stat.
    • Hormonal system:
    • Pregnancy hormone decrease and not
    present after the delivery of the placenta such
    as HPL and HCG
    Urinary system
    • Duresis phase begin immediately after birth to
    get rid of fluid that accumulated in pregnancy,
    • About 3000cc per day.

    • Transient loss of bladder tone due to pressure


    from the pregnancy and delivery.

    • Encourage women to void Q2hr


    Circulation
    • Duresis phase and blood lost during delivery
    decrease the blood volume added in
    pregnancy .
    • Normal blood loss in normal delivery is 300-500
    and 500-1000 in C/S
    • Fibrinogen high for one week post partum to
    decrease the risk of PPH but increase the risk of
    thrombus formation such as DVT deep vein
    thrombosis.
    GI System
    • The digestion and absorption are active after
    birth and the women feel hungry and thirsty.
    •
    • Constipation may present due to effect of
    relaxin
    The integumentary system
    • The stretch marks (striae gravidarum) still
    appear red and more prominent than in
    pregnancy
    Physiological changes ……..
    • Weight loss : depend on the weight of the
    baby , placenta ,lochia, and diaphoresis.
    • The women need 6th week to return to pre
    pregnant stat, some of them didn’t.
    • Temp: the women may show increase in temp
    for the 1st 24hr post delivery due to
    dehydration about 38C.
    Physiological changes ……..
    • The pulse: in general slower than normal
    return to normal within the 1st week.
    • Rapid , thready pulse and low BP may indicate
    bleeding.
    • BP should return to normal and compared to
    pre pregnant stat not to the pregnancy.
    • Note: BP may increase with Oxytocin
    24hr Nsg care post partum

    • Observe V/S regularly BP, Temp, pulse.


    • Uterine massage (contractility), involution and
    amount of lochia.
    • Encourage women to increase fluid intake.
    • Provide analgesia for after pains.
    • Encourage lactation
    • Encourage rest and exercise
    • Hygiene and perineal care.
    • Provide psychological support and teaching.
    • nutrition

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