Puerperium

Puerperium (period after childbirth)

A woman's genitals return to their pre-pregnancy state and the uterus contracts or shrinks, the birth injury heals, and the mammary gland begins to produce milk. The wrapping of the uterus occurs as early as one hour after birth and lasts about 2 weeks. Small remnants of the placenta together with vascular thrombi leave the uterus as discharge (lochia) - the discharge can be infectious. Under the influence of prolactin, the mammary gland produces colostrum in the first two days after birth, after which the own production of breast milk begins - lactation. In addition to skin hygiene, the prevention of mammary gland inflammation is also the correct technique of breastfeeding and pumping or expressing excess milk.

Investigation:

• ultrasound,
• gynecological examination,
• breast examination.

Monitoring:

• physical and mental manifestations,
• dam condition,
• TT, shivering, bleeding,
• leaving purgatory
• DK status,
• birth injury,
• onset of lactation,
• the mother's relationship with the newborn.

We measure BP. Heart rate is measured 2 hours after birth in 15 minute intervals. Then it is measured for 2 hours in 30 minute intervals and after that 3 times a day.

Hygiene:

• help as needed,
• washing parents several times a day,
• handling of used and sterile pads.

Nursing care:

• hygiene aids – package of sterile pads,
• we teach the patient about the principles of managing basic hygiene habits.
• We look at:

• FF – TK, P, TT;
• departure of purifications - amount and appearance;
• wrapping the uterus;
• episiotomy – dryness, secretion and healing;
• the level of hygiene performed;
• breasts, nipples;
• results of laboratory examinations;

• we check the emptying of urine - spontaneously 6 hours after birth;
• we control the emptying of the stool;
• we carry out rehabilitation - prevention of thromboembolic complications and strengthening of the muscles of the abdominal wall and pelvic floor;
• enough rest and sleep.

Check for purges:

• the departure of the cleansing takes 2-3 weeks, at the end of the sixth trimester, it disappears completely;
• 1.-3. day the secretion is bloody;
• from the 4th day, the secretion is serous (yellow-brown);
• at the end of the 1st week, the purging is watery/mucous.

Wrapping the uterus:

• 1st day – uterine fundus at the level of the navel,
• 2nd day – uterine fundus 1 finger below the navel,
• 3-4 day - the bottom of the uterus is 2 fingers below the navel,
• 5-8 day - the bottom of the uterus is between the navel and the symphysis,
• 9-10 day - the bottom of the uterus is 2 fingers below the pubic clasp,
• after 14 days - normal size.

Links

Related Articles

• Birth
• Maternal mortality
• Breastfeeding
• Oxytocin
• Thromboembolic disease in gynecology
• Warfarin

External links

• to do after childbirth - changes in the sixth trimester
• Nursing care of a woman during six months of childbirth
• Six weeks

Source

• weeks OP in six weeks

Recommended literature

• KOUDELKOVÁ, Vlasta. Ošetřovatelská péče o ženy v šestinedělí. 1. edition. Praha : Triton, 2013. ISBN 978-80-7387-624-1.