Medicine an Surgery notes

Apr 24th, 2015
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Normal and AbnormalPuerperiumLiu WeiDepartment of Ob & GyRen Ji hospitalNormal Puerperium Definition1. The time from the delivery of the placentathrough the first few weeks after the delivery.2. 6 weeks in duration.3. By 6 weeks after delivery, most of the changesof pregnancy, labor, and delivery haveresolved and the body has reverted to thenonpregnant state.Normal Puerperium1.1)The relevant anatomy and physiology in thepuerperiumReproductive organsUterus1000g 50-100gThe endometrial lining rapidly regenerates(16 days)The placental site undergoes a series ofchanges in the postpartum periodNormal Puerperium2) Cervix it never returns to the nulliparous state. the external os is closed to the extent that afinger could not be easily introduced.3) Vagina shrinks to a nonpregnant state resolution of the increased vascularity andedema occurs by 3 weeks the vaginal epithelium appears atrophic onsmear. This is restored by weeks 6-10.Normal Puerperium4) Perineum swelling and engorgement are completelygone within 1-2 weeks the muscle tone may or may not return tonormal, depending on the extent of injury.5) Ovaries ovulate as early as 27 days after delivery (notbreastfeed ); 12 weeks (most); 7-9 weeks(mean). the suppression of ovulation due to theelevation in prolactinNormal Puerperium6) Breasts Lactation can occur by 16 weeks' gestation. Lactogenesis is initially trigger

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