Thenormalpuerperiumanditscomplication-曾雅畅.ppt

The normal puerperium and its complication Review The normal puerperium Must know details of: Includes 6 weeks postpartum during which normal pregnancy involution occurs. After pregnancy and delivery when the anatomic and physiologic changes to the normal non-pregnant state. The normal puerperium Immediate puerperium The first 24 hours after parturition. the acute postdelivery complications may occur The early puerperium Extend until the first week postpartum. The remote puerperium 2— 6 week. Uterine Changes the time required for involution of the genital organs. Involution of uterine corpus. Weight of uterus?? ?1000g?soon thereafter 100g or less?? ?: total number of muscle cells does not decrease → individual cells decrease in size. Uterine Changes Endometrial regeneration ?? ? the remain decidua becomes differentiated into 2 layers. Uterine Changes Endometrial regeneration is rapid, except at the placental site. ???? - free surface becomes covered by epithelium within a week or so entire endometrium is restored during the 3rd week. Uterine Changes Changes in the uterine vessels Extra uterine vessel----- Decrease to equal size of prepregnant state after delivery. Blood vessels within uterus ????? :? obliterated by hyaline change replaced by smaller vessels. Uterine Changes Changes in the Cervix: Bilateral depression at the site of lacerations remain as permanent changes that characterize the parous cervix. Uterine Changes Changes in the Cervix : Cervical opening contracts slowly and for a few days immediately after labor. (?≒ 2fingers ) As the opening narrows the cervix thickens and a canal reforms. ? by the end of the 1st wk → it has narrowed Abdominal wall ligaments and Abdominal wall ???? much more lax than nonpregnant and require considerable time to recover from stretching loosening. ??? : return to normal → requires several weeks ??? : usually resumes its prepregnancy state except for silve