N4341 - Exam 3 (OB - Hoolapa/Welch)
N4341 - Exam 3 (OB - Hoolapa/Welch)
Define involution
What is it's opposite? - ANSWER clamping/shrinking of uterus
opposite: subvolution (bad! at risk for PPH)
Discuss the progress expected during involution (4) - ANSWER returns to 16w size immediately after
delivery
descends 1-2 cm q 24 H
6d = halfway btw symphysis & umbilicus
9d = no longer palpable
During postpartum, when is the fundus no longer palpable? - ANSWER 9-10 days after delivery
Define FF U-2 - ANSWER fundus firm and 2 fingers below umbilicus
(opposite of fetal station)
Increased risk of subvolution (5) - ANSWER long labor
full bladder
overdistended uterus (multipara OR hydramnios)
Define the different types of lochia and when they are expected - ANSWER rubra: red & bloody, birth to
4 days
serosa: pink/brown, day 4 - day 22
alba: whitish, can last 6 weeks or longer (typical 10-14 days)
Who would you expect to have more bleeding after delivery; multi or primipara? - ANSWER multi
Normal EBL for c/s vs vag - ANSWER c/s: 1000 mL
, N4341 - Exam 3 (OB - Hoolapa/Welch)
vag: 500 mL
After delivery, the cervix has a permanent appearance of what?
When does os close? - ANSWER "fish mouth" appearance
os closes over 2 weeks
When is vagina expected to return to normal size after delivery?
Discuss vaginal mucosa - ANSWER normal size: 6-8 weeks
↓ mucosa ∵ ↓estrogen from lactation
What would you expect of estrogen levels after delivery?
progesterone?
prolactin? - ANSWER ↓ estrogen = LOTS of sweating/peeing (lose 5lbs)
↓ progesterone
↑ prolactin
When does ovulation begin in non-breastfeeding moms?
Menses?
Ovulation in breastfeeding moms? - ANSWER ovulation: 27 days
menses: 6-12 weeks
*can get pregnant before menses*
BF moms: 6 months
Postpartum mom has a heart rate of 51, should you be concerned? - ANSWER not necessarily
HR ↓ after delivery now that blood not being shunted to fetus (tells heart to slow rate)
What would you expect of H&H in pregnant woman? - ANSWER HIGH! have anemic state but ↓ plasma
from diuresis
N4341 - Exam 3 (OB - Hoolapa/Welch)
Define involution
What is it's opposite? - ANSWER clamping/shrinking of uterus
opposite: subvolution (bad! at risk for PPH)
Discuss the progress expected during involution (4) - ANSWER returns to 16w size immediately after
delivery
descends 1-2 cm q 24 H
6d = halfway btw symphysis & umbilicus
9d = no longer palpable
During postpartum, when is the fundus no longer palpable? - ANSWER 9-10 days after delivery
Define FF U-2 - ANSWER fundus firm and 2 fingers below umbilicus
(opposite of fetal station)
Increased risk of subvolution (5) - ANSWER long labor
full bladder
overdistended uterus (multipara OR hydramnios)
Define the different types of lochia and when they are expected - ANSWER rubra: red & bloody, birth to
4 days
serosa: pink/brown, day 4 - day 22
alba: whitish, can last 6 weeks or longer (typical 10-14 days)
Who would you expect to have more bleeding after delivery; multi or primipara? - ANSWER multi
Normal EBL for c/s vs vag - ANSWER c/s: 1000 mL
, N4341 - Exam 3 (OB - Hoolapa/Welch)
vag: 500 mL
After delivery, the cervix has a permanent appearance of what?
When does os close? - ANSWER "fish mouth" appearance
os closes over 2 weeks
When is vagina expected to return to normal size after delivery?
Discuss vaginal mucosa - ANSWER normal size: 6-8 weeks
↓ mucosa ∵ ↓estrogen from lactation
What would you expect of estrogen levels after delivery?
progesterone?
prolactin? - ANSWER ↓ estrogen = LOTS of sweating/peeing (lose 5lbs)
↓ progesterone
↑ prolactin
When does ovulation begin in non-breastfeeding moms?
Menses?
Ovulation in breastfeeding moms? - ANSWER ovulation: 27 days
menses: 6-12 weeks
*can get pregnant before menses*
BF moms: 6 months
Postpartum mom has a heart rate of 51, should you be concerned? - ANSWER not necessarily
HR ↓ after delivery now that blood not being shunted to fetus (tells heart to slow rate)
What would you expect of H&H in pregnant woman? - ANSWER HIGH! have anemic state but ↓ plasma
from diuresis
