MCN 273 POST PARTUM 1: YOUR A+ GUIDE THROUGH
QUESTIONS AND ANSWERS.
is lochia rubra normal the first 3 days after delivery?
yes
what does uterine involution mean?
gradual reduction in size to pre - pregnancy condition (involves contraction of uterine muscle)
what else is involved in uterine involution besides contraction of uterine muscle?
healing of placental wound site
how long does uterine involution take to happen?
6 weeks
what are 5 things that could affect the normal process of uterine involution? what is this
abnormal process called?
over distention of uterus, overworked uterus, retained placenta or clots, infection, full bladder;
this is called sub involution
what are some things that could cause over distention of the uterus and cause a sub
involution?
multiple gestation or polyhydramnios
what are some things that could cause an overworked uterus and cause a sub involution?
multiparity, long labor, induction or augmentation of labor with pitocin
what is the risk if you give pitocin or oxytocin?
postpartum hemmorrhage risk increases along with subinvolution risk bc making uterus work
even harder w those meds
why would having a full bladder cause a subinvolution?
uterus cannot contract the way its supposed to
what are normal findings for the fundus after delivery?
U/U at 4th stage of delivery and will drop 1 cm each day postpartum (1 cm=1 fingerbreadth).
also make sure to check if uterus is at midline or if its deviated
what are two abnormal findings with the fundus after delivery?
, if its higher than normal in the abdomen or if its deviated from the midline
what are some reasons that the fundus would be higher than normal?
part of clots or part of the placenta is left behind
what would be a reason that the uterus is deviated from midline?
full bladder
what are normal findings w the lochia? (what should the lochia look like for how many days
PP)
normal progress of wound healing
lochia rubra: red and should be happening 3-4 days PP
lochia serosa: pinkish and should be happening 3-10 days PP
lochia alba: white/yellow and should be happening 10-14 days PP
what would be an abnormal lochia finding?
lochia rubra after 4 days PP (could be parts of placenta left behind)
if someone is soaking a pad is this ever ok?
no too much bleeding
how much should the fundus of the uterus sink below the umbilicus each day?
1 cm down each postpartum day (U/1 on day one, U/2 on day 2... etc.) -- after delivery fundus
should be right at the midline
what are cervical changes after delivery?
spongy and formless shape -- shape of the external os is permanently changed
if someone has given birth vaginally (parous) the cervix will almost have a horizontal slit but if
nulliparous aka not given vaginal birth then it will be just a hole
what are some vaginal changes after delivery?
edematous, bruised and dryness is common
when should vagina go back to its normal size after pregnancy?
6 wks after delivery
what are some perineal changes after delivery?
episiotomy and laceration edges, also could have hemorrhoids
QUESTIONS AND ANSWERS.
is lochia rubra normal the first 3 days after delivery?
yes
what does uterine involution mean?
gradual reduction in size to pre - pregnancy condition (involves contraction of uterine muscle)
what else is involved in uterine involution besides contraction of uterine muscle?
healing of placental wound site
how long does uterine involution take to happen?
6 weeks
what are 5 things that could affect the normal process of uterine involution? what is this
abnormal process called?
over distention of uterus, overworked uterus, retained placenta or clots, infection, full bladder;
this is called sub involution
what are some things that could cause over distention of the uterus and cause a sub
involution?
multiple gestation or polyhydramnios
what are some things that could cause an overworked uterus and cause a sub involution?
multiparity, long labor, induction or augmentation of labor with pitocin
what is the risk if you give pitocin or oxytocin?
postpartum hemmorrhage risk increases along with subinvolution risk bc making uterus work
even harder w those meds
why would having a full bladder cause a subinvolution?
uterus cannot contract the way its supposed to
what are normal findings for the fundus after delivery?
U/U at 4th stage of delivery and will drop 1 cm each day postpartum (1 cm=1 fingerbreadth).
also make sure to check if uterus is at midline or if its deviated
what are two abnormal findings with the fundus after delivery?
, if its higher than normal in the abdomen or if its deviated from the midline
what are some reasons that the fundus would be higher than normal?
part of clots or part of the placenta is left behind
what would be a reason that the uterus is deviated from midline?
full bladder
what are normal findings w the lochia? (what should the lochia look like for how many days
PP)
normal progress of wound healing
lochia rubra: red and should be happening 3-4 days PP
lochia serosa: pinkish and should be happening 3-10 days PP
lochia alba: white/yellow and should be happening 10-14 days PP
what would be an abnormal lochia finding?
lochia rubra after 4 days PP (could be parts of placenta left behind)
if someone is soaking a pad is this ever ok?
no too much bleeding
how much should the fundus of the uterus sink below the umbilicus each day?
1 cm down each postpartum day (U/1 on day one, U/2 on day 2... etc.) -- after delivery fundus
should be right at the midline
what are cervical changes after delivery?
spongy and formless shape -- shape of the external os is permanently changed
if someone has given birth vaginally (parous) the cervix will almost have a horizontal slit but if
nulliparous aka not given vaginal birth then it will be just a hole
what are some vaginal changes after delivery?
edematous, bruised and dryness is common
when should vagina go back to its normal size after pregnancy?
6 wks after delivery
what are some perineal changes after delivery?
episiotomy and laceration edges, also could have hemorrhoids
