The uterus
- Involution - is the process whereby the uterus returns to its nonpregnant state.
- The 2 main processes involved are: sealing of the portion where placenta was the rapid contraction of the uterus following placental expulsion.
- Usually takes 6 weeks to complete.
- Measured by fingerbreadths:
– 1hour after delivery to 24 hours = above umbilicus.
– Then, a decrease of 1 fingerbreadth/day, which is approximately equal to 1 cm. It should no longer be detected by the 9th to 10th postpartum day.
- Faster in breastfeeding women due to release of oxytocin.
- Process may be retarded secondary to conditions such as multiple fetuses, hydramnios, and grand multiparity among others.
- After pains are cramps similar to that felt with menstrual period, which is caused by the contraction of the uterus. Most common in women who are multiparous, and mothers who delivered large babies.
- Lochia - uterine flow, consisting of blood, fragments of decidua, WBC, mucus, and some bacteria.
- This sloughing off will cleanse the uterus and will return to its reproduction state in 3 weeks. The placental implantation site takes approximately 6 weeks to be cleansed and healed.
|
Type |
Color |
Duration (day) |
Composition |
|
Rubra |
Red |
1-3 |
Blood fragments of decidua and mucus. |
|
Sirossa |
Pink or brown |
3-10 |
Blood, mucus, and invading leukocytes. |
|
Alba |
White |
10-14 (even 6 weeks) |
Large mucus, leukocyte count increase. |
Cervix
- Soft and malleable post pregnancy.
- Contraction begins at once. After 7 days, external os is narrowed and it feels firm and non-gravid again.
- There is formation of new muscle cells.
Vagina
- Soft, few rugae, diameter is considerably less than normal.
- Hymen is permanently torn and heals in small separate tags of tissue.
Perineum
- Portions may show ecchymosis from the rupture of surface capillaries.
- L. majora and l. minora typically remain atrophic and softened.
- Presence of episiotomy incisions.