NM705 EXAM 4 QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS VERIFIED LATEST UPDATE
Describe the physiological and anatomical changes of the uterus postpartum:
Uterus involutes approximately 50% in first 24-48 hours then gradually diminishes to the
nonpregnant size over the next 6-8 weeks. Takes longer in multips than primips. 1 week
PP, endometrial surface is epithelized; 2-3 weeks PP, endometrium regenerated and
resembles non-pregnant epithelium except for placental site. Thrombosed vessels at
placental implantation site take 6 weeks to heal through sloughing of tissue, then
endometrial remodeling. Uterus is a pelvis organ at 2 weeks PP.
Describe the physiological and anatomical changes of the cervix postpartum:
External os does not return to prepregnant state, looks like slit instead of dimple.
Cervical endothelium undergoes remodeling, associated w/ high incidence of
spontaneous regression of high-grade cervical epithelial lesions.
Describe the physiological and anatomical changes of the vagina postpartum:
Initially edematous and bruised after vaginal birth, loss of tone and rugae. Rugae return
3-4 weeks PP. Prepregnant tone may never be completely restored. Hymenal ring
replaced by hymenal tags. Vaginal opening becomes visible rather than closed by labia
minora.
Discuss lochia after childbirth:
Begins at birth and continues 4-8 weeks. Mean total duration 33 days.
, Lochia rubra 3-5 days PP, lochia serosa up to 10 days PP, lochia alba up to 4-8 weeks
PP. Each day, the amount of bleeding should be less and the color lighter. Eschar
bleeding may occur at 10 day PP - "scab" from placental site released - heavier,
brighter red bleeding may occur for a few hours.
Describe the physiological and anatomical changes of the breasts postpartum:
Not breastfeeding ~ lack of prolactin → mammary epithelial cell apoptosis and involution
Regardless of breastfeeding ~ some mammary epithelium is retained thus never return
to prepregnancy state
Timing and process of mammary involution depends on breastfeeding or not
No BFing → prolactin decrease within1 week due to no sucking → mammary involution
BFing - full mammary involution takes months
Describe the physiological and anatomical changes of the GI system postpartum:
Gastric tone and motility remain decreased for 2-3 days PP
BMs resume 2-3 days PP, normal GI function and bowel patterns return 1-2 weeks PP
Decreased GI motility in the PP period can lead to abdominal distension, constipation,
and ileus
Describe the physiological and anatomical changes of the renal system
postpartum:
Gradual return to non-pregnant values of GFR, renal plasma flow, plasma creatinine,
BUN, creatinine clearance by 2-3 months PP.
Mild proteinuria may develop 3-5 days PP
Natriuresis (Na+ excretion) and diuresis lead to decrease in blood volume, return to
prepregnant levels - 3 weeks or less.
COMPLETE SOLUTIONS VERIFIED LATEST UPDATE
Describe the physiological and anatomical changes of the uterus postpartum:
Uterus involutes approximately 50% in first 24-48 hours then gradually diminishes to the
nonpregnant size over the next 6-8 weeks. Takes longer in multips than primips. 1 week
PP, endometrial surface is epithelized; 2-3 weeks PP, endometrium regenerated and
resembles non-pregnant epithelium except for placental site. Thrombosed vessels at
placental implantation site take 6 weeks to heal through sloughing of tissue, then
endometrial remodeling. Uterus is a pelvis organ at 2 weeks PP.
Describe the physiological and anatomical changes of the cervix postpartum:
External os does not return to prepregnant state, looks like slit instead of dimple.
Cervical endothelium undergoes remodeling, associated w/ high incidence of
spontaneous regression of high-grade cervical epithelial lesions.
Describe the physiological and anatomical changes of the vagina postpartum:
Initially edematous and bruised after vaginal birth, loss of tone and rugae. Rugae return
3-4 weeks PP. Prepregnant tone may never be completely restored. Hymenal ring
replaced by hymenal tags. Vaginal opening becomes visible rather than closed by labia
minora.
Discuss lochia after childbirth:
Begins at birth and continues 4-8 weeks. Mean total duration 33 days.
, Lochia rubra 3-5 days PP, lochia serosa up to 10 days PP, lochia alba up to 4-8 weeks
PP. Each day, the amount of bleeding should be less and the color lighter. Eschar
bleeding may occur at 10 day PP - "scab" from placental site released - heavier,
brighter red bleeding may occur for a few hours.
Describe the physiological and anatomical changes of the breasts postpartum:
Not breastfeeding ~ lack of prolactin → mammary epithelial cell apoptosis and involution
Regardless of breastfeeding ~ some mammary epithelium is retained thus never return
to prepregnancy state
Timing and process of mammary involution depends on breastfeeding or not
No BFing → prolactin decrease within1 week due to no sucking → mammary involution
BFing - full mammary involution takes months
Describe the physiological and anatomical changes of the GI system postpartum:
Gastric tone and motility remain decreased for 2-3 days PP
BMs resume 2-3 days PP, normal GI function and bowel patterns return 1-2 weeks PP
Decreased GI motility in the PP period can lead to abdominal distension, constipation,
and ileus
Describe the physiological and anatomical changes of the renal system
postpartum:
Gradual return to non-pregnant values of GFR, renal plasma flow, plasma creatinine,
BUN, creatinine clearance by 2-3 months PP.
Mild proteinuria may develop 3-5 days PP
Natriuresis (Na+ excretion) and diuresis lead to decrease in blood volume, return to
prepregnant levels - 3 weeks or less.
