Puerperium


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puerperium

[‚pyü·ər′pir·ē·əm]
(medicine)
The state of a woman during labor or immediately after delivery.
The period from delivery to the time when the uterus returns to normal size, about 6 weeks.

Puerperium

 

the period that begins after the expulsion of the placenta and continues for six to eight weeks. During puerperium almost all the systems and organs that underwent changes during pregnancy and childbirth return to their normal state. The uterus, whose fundus is 15 cm above the pubis after childbirth, contracts and after ten to 12 days disappears behind the pubis. Its weight drops from 1,000 g to 50–60 g by the end of the eighth week. The internal opening of the cervix closes by the tenth day after childbirth; the external opening closes by the end of the third week.

As the uterus contracts, its mucous membrane gradually covers the interior surface of the uterus; complete restoration of the epithelial covering occurs by the end of the third postnatal week. Before completion of this process, the interior surface of the uterus consists of an extensive wound surface, which produces a characteristic discharge known as lochia. The discharge, which is initially bloody, becomes light in color and bloodless by the tenth day. During puerperium, the tonus of the vagina is restored, and abrasions and lacerations of the external genitalia, vagina, and cervix heal. Gradually the overstretched ligaments of the uterus contract, and the fallopian tubes and the ovaries assume their usual state. Lactation begins on the third or fourth day after childbirth.

The general condition of the puerpera is good: the pulse is regular and seldom retarded (physiological bradycardia), and arterial pressure is normal. The body temperature is usually normal; a slight elevation immediately after childbirth may occur. During puerperium, aseptic and antiseptic measures must be strictly implemented, because the wound surface of the uterus, the abrasions and lacerations of the soft tissues of the birth canal, and cracks in the nipples may serve as loci of penetration for infectious agents, which can cause puerperal fever. The external genitalia and the breasts should be cleansed daily during the puerperium.

From the second day after normal childbirth, healthy women are prescribed a set of exercises that tone up the body and promote more rapid contraction of the uterus. If the puerperal period proceeds without complications and the physiological development of the newborn is normal, the mother and infant are discharged from the maternity hospital on the sixth or seventh postnatal day. Women with elevated temperatures, upper respiratory infections, skin abscesses, and other symptoms of infection are hospitalized in a special department of the maternity hospital.

REFERENCE

Kogan, A. A. ‘Normal’nyi poslerodovoi period.” In Mnogotomnoe rukovodstvo po akusherstvu i ginekologii, vol. 2, book 2. Moscow, 1963.

A. P. KIRIUSHCHENKOV

References in periodicals archive ?
In this study, it was found that most women expressed a firm intention to breastfeed in the immediate puerperium, but the proportion who finally breast-fed their babies during the first six months was low; very few provided LME during the recommended time.
These changes along with an inhibited fibrinolytic system result in a marked increase in fibrin generation during pregnancy and puerperium. This hypercoagulable state along with conditions resulting in dehydration during labour and puerperium may be responsible for thrombotic complications in pregnancy including cerebral venous thrombosis.
Finally, although this manuscript does not propose to exhaust the subject on the senses of excessive weight gain in pregnancy, it is expected that it may contribute to the planning of policies and orientation of behaviors aimed at humanization and integrality of the actions of food and nutrition in the prenatal care and puerperium, based on the establishment of horizontal dialogues between professionals and users, and on reference flows for psychological and nutritional followup of pregnant women assisted by Primary Health Care in the city of Macae-RJ.
Over time there was an increase in the rate of AMI during pregnancy and the puerperium (adjusted odds ratio, 1.25 for 2014 versus 2002).
Therefore, before the mother leaves the hospital after birth, the characteristics of "losia" (A type of flux that occurs generally during the whole puerperium) and fundus massage should be taught, and the woman should be reminded that the bleeding will increase during breastfeeding, and if abnormalities occur with the characteristics of "losia" she should visit a medical institution.
Normal haematological changes during pregnancy and the puerperium. In: Pavord S, Hunt B, editors.
Thus, we have conducted a retrospective study in 14 female patients of childbearing age with newly-onset demyelinating attacks during puerperium and explored the possible pathogenesis.
Only 3,3% (n=15) of cases are identified as "O24.0-Pre-existing diabetes mellitus, type 1, in pregnancy, childbirth and the puerperium".
(13) In the postpartum period, the fibrinogen concentration decreases after delivery and may remain low during the immediate puerperium. (15) Although the reason for the decrease in fibrinogen concentration after birth is not fully understood, it has been postulated that an increase in intravascular fibrin deposits occurs after delivery, increasing fibrinogen consumption.
Beginning with pregnancy risk category III, the WHO guidelines recommend intensive cardiac and obstetric monitoring throughout pregnancy, childbirth, and the puerperium. Several maternal-fetal medicine specialists interviewed all agreed that an interdisciplinary team is a must for good obstetric care in this population.
Logitudinal study of serum lipids and lipoproteins in normal pregnancy and puerperium. Trop Geogr Med.
Pregnancy, childbirth and the puerperium. In International Statistical Classification of Diseases and Related Health Problems (10th rev.).