Postpartum Lecture Review
1. Describe involution
Involution in postpartum means mammalian tissue remodeling that occurs after
pregnancy and lactation to return the gland to the pre-pregnant condition.
2. Where should I expect to find a woman’s fundus at 24 hours postpartum? 48
hours postpartum? 72 hours postpartum?
Fundus 24 hours postpartum should be 1 cm, 48 hours-2 cm and 72 hours-3cm below
belly button.
2. What are after pains?
After-pains are contractions that occur after labor and delivery. These contractions
signal the process of involution, the uterus shrinking back down to its pre-pregnancy
size and shape.
3. Which of the following mothers are more likely to have stronger after pains?
Breastfeeding mothers more likely to have stronger after pains because lactation can
trigger the contractions after birth.
4. What is lochia?
The normal part of postpartum healing in which the uterus sheds blood and tissue no
longer needed to maintain the pregnancy. The body’s way of removing the excess
blood and discharge from the uterus after giving birth.
6. What days would I expect to see:
Rubra 1-3 days dark red in color
Serosa 4-11 days pinkish in color
Alba 12 days -6 weeks whitish yellow in color
7. What is colostrum? When does a woman’s milk come in?
Colostrum liquid, thick and golden color first milk. It has very good nutrient for the
newborn. Colostrum transitions to milk about 72-96 hour after birth.
8. What is engorgement? How long does it last?
Engorgement is filling of the breasts with increase amount of milk for the feeding of the
baby. It last about 7 to 10 days.
9. Define expected blood loss for a vaginal delivery (in mLs). For a C/S?
For vaginal delivery is about 500ml and for C/S about 1500ml.
, 10. Describe the expected changes in vital signs in the immediate postpartum period
- Temporary increase in Cardiac Output and resultant bradycardia for first 48 hours
- The body rids itself of the extra plasma volume of pregnancy through diuresis and
diaphoresis
- Increase in coagulation (risk for DVT): Homan’s sign
- Anemia may occur if excess blood lost during delivery
- Varicosities and hemorrhoids common
11. What are the expected ranges of WBC in the immediate postpartum period?
The expected ranges of WBC are 20,000-30,000 postpartum period. WBC will return to
normal within one week.
12. Describe the trend of clotting factors in the immediate postpartum period? What
complication should you be vigilant for because of this trend? How would you offset
this complication?
Postpartum hemorrhage—any blood loss from the uterus that exceeds 500 ml during a
24-hour period—is the major cause of maternal mortality. The danger of postpartum
hemorrhage due to uterine atony is greatest during the first hour after birth. During this
time, the placenta has detached, leaving the highly vascular yet denuded uterus widely
exposed. The risk continues to be high for 24 hours after birth. Emergency treatment
depend on prompt and adequate blood and fluid replacement to restore intravascular
volume and to raise blood pressure and maintain it above 60 mm Hg. Rapid infusion of
lactated Ringer solution and, possibly, albumin or other plasma expanders may be needed
to expand volume adequately until whole blood can be matched.
13. Which hormone is responsible for stimulating milk production? Which
hormone is responsible for the milk ejection reflex?
Prolactin is responsible for the milk production. Oxytocin is responsible for the milk
ejection reflex.
14. Describe the trend of the basal metabolic rate in the postpartum period? What
physical finding would you expect to see because of this trend?
Basal metabolic rate will be higher and will go to normal after 1 year. Breastfeeding
during the postpartum stage keeps the metabolism high, causing moms to lose more
weight than women who chose not to breastfeed.
15. Describe the role of estrogen with fluid loss in the immediate postpartum
period?
The postpartum period is the period after delivery of conceptus when maternal
physiological and anatomical changes return to the nonpregnant state. The postpartum
period, also known as puerperium, starts following the expulsion of the placenta until
complete physiological recovery of various organ systems
1. Describe involution
Involution in postpartum means mammalian tissue remodeling that occurs after
pregnancy and lactation to return the gland to the pre-pregnant condition.
2. Where should I expect to find a woman’s fundus at 24 hours postpartum? 48
hours postpartum? 72 hours postpartum?
Fundus 24 hours postpartum should be 1 cm, 48 hours-2 cm and 72 hours-3cm below
belly button.
2. What are after pains?
After-pains are contractions that occur after labor and delivery. These contractions
signal the process of involution, the uterus shrinking back down to its pre-pregnancy
size and shape.
3. Which of the following mothers are more likely to have stronger after pains?
Breastfeeding mothers more likely to have stronger after pains because lactation can
trigger the contractions after birth.
4. What is lochia?
The normal part of postpartum healing in which the uterus sheds blood and tissue no
longer needed to maintain the pregnancy. The body’s way of removing the excess
blood and discharge from the uterus after giving birth.
6. What days would I expect to see:
Rubra 1-3 days dark red in color
Serosa 4-11 days pinkish in color
Alba 12 days -6 weeks whitish yellow in color
7. What is colostrum? When does a woman’s milk come in?
Colostrum liquid, thick and golden color first milk. It has very good nutrient for the
newborn. Colostrum transitions to milk about 72-96 hour after birth.
8. What is engorgement? How long does it last?
Engorgement is filling of the breasts with increase amount of milk for the feeding of the
baby. It last about 7 to 10 days.
9. Define expected blood loss for a vaginal delivery (in mLs). For a C/S?
For vaginal delivery is about 500ml and for C/S about 1500ml.
, 10. Describe the expected changes in vital signs in the immediate postpartum period
- Temporary increase in Cardiac Output and resultant bradycardia for first 48 hours
- The body rids itself of the extra plasma volume of pregnancy through diuresis and
diaphoresis
- Increase in coagulation (risk for DVT): Homan’s sign
- Anemia may occur if excess blood lost during delivery
- Varicosities and hemorrhoids common
11. What are the expected ranges of WBC in the immediate postpartum period?
The expected ranges of WBC are 20,000-30,000 postpartum period. WBC will return to
normal within one week.
12. Describe the trend of clotting factors in the immediate postpartum period? What
complication should you be vigilant for because of this trend? How would you offset
this complication?
Postpartum hemorrhage—any blood loss from the uterus that exceeds 500 ml during a
24-hour period—is the major cause of maternal mortality. The danger of postpartum
hemorrhage due to uterine atony is greatest during the first hour after birth. During this
time, the placenta has detached, leaving the highly vascular yet denuded uterus widely
exposed. The risk continues to be high for 24 hours after birth. Emergency treatment
depend on prompt and adequate blood and fluid replacement to restore intravascular
volume and to raise blood pressure and maintain it above 60 mm Hg. Rapid infusion of
lactated Ringer solution and, possibly, albumin or other plasma expanders may be needed
to expand volume adequately until whole blood can be matched.
13. Which hormone is responsible for stimulating milk production? Which
hormone is responsible for the milk ejection reflex?
Prolactin is responsible for the milk production. Oxytocin is responsible for the milk
ejection reflex.
14. Describe the trend of the basal metabolic rate in the postpartum period? What
physical finding would you expect to see because of this trend?
Basal metabolic rate will be higher and will go to normal after 1 year. Breastfeeding
during the postpartum stage keeps the metabolism high, causing moms to lose more
weight than women who chose not to breastfeed.
15. Describe the role of estrogen with fluid loss in the immediate postpartum
period?
The postpartum period is the period after delivery of conceptus when maternal
physiological and anatomical changes return to the nonpregnant state. The postpartum
period, also known as puerperium, starts following the expulsion of the placenta until
complete physiological recovery of various organ systems
