Chapter 12 Physiological Changes That Occur After Birth -...

Chapter 12: Postpartum Notes
Physiological Changes That Occur After Birth
 Reproductive System
o Uterus returns to pre-pregnant size, shape, and location
 Uterus descend 1 cm/day; by day 14 Fundus descended into the pelvis and not
palpable
o Afterpains – moderate to severe cramp-like pains r/t uterus working to remain
contracted and/or to increase of oxytocin released in response to infant suckling
 Endometrium:
o Undergoes exfoliation and regeneration after placental birth through necrosis of
superficial layer of the decidua and regeneration of decidua basalis into endometrial
tissue
o Lochia- bloody discharge from the uterus containing sloughed necrosis tissue
 Undergoes healing process of the uterine placental site
 Lochia rubra –
 Day 1 – 3
 Normal findings:
o Bloody with small clots
o Moderate to scant amount
o Increased flow on standing or breastfeeding
o Fleshy odor
 Abnormal findings
o Large clots
o Heavy amount; saturates pad within 15 minutes
o Foul odor
o Placental fragments
 Lochia serosa –
 Day 4 – 10
 Normal findings
o Pink or brown coloration
o Scant amount
o Increased flow during physical activity
o Fleshy odor
 Unexpected findings
o Continuation of rubra stage after 4
o Heavy amount
o Heavy amount; saturates pad within 15 minutes
o Foul odor
 Lochia alba –
 Day 10
 Normal findings:
o Yellow to white in color
o Scant amount
o Fleshy odor
 Anomalies:
o Bright red bleeding

Chapter 12: Postpartum Notes
o Foul odor
 Vagina and Perineum:
o Primary complication = infection
o Experience changes r/t birthing; tears, stretching, episiotomies
 Breasts:
o Primary engorgement (subsides 24 - 48 hrs)
 Occurs 2 to 3 days after birth
 Increase in vascular and lymphatic system of breasts
 Preceded the initiation of milk production
o Larger, firmer, warm, tender
o May feel throbbing pain
o Breastfeeding women:
 Subsequent engorgement r/t distention of milk glands that is relieved by feeding
the baby or pumping
o Primary complication is mastitis
o Colostrum clear, yellowish fluid preceding milk production
 High in protein
 Low in carbohydrates
 Contain IgG and IgA
 Cardiovascular:
o Avg blood loss 200-500mL
o WBC may increase to 25,000/mm
 Return to normal within 7 days
o CO returns to normal within 48 hours
o