Obstetrics and Gynaecology · MU Sofia

13. The normal puerperium. Postnatal care

Covers the six-week puerperium and how the body returns to its non-pregnant state, with lactation starting in the breasts. Includes a table of normal changes in the uterus, lochia, cervix, cardiovascular system, blood and ovaries, then a list of postnatal care checks and treatments. Also presents a table comparing baby blues, postnatal depression and puerperal psychosis, and notes a warning sign of endometritis or retained products.

Inside: 3 sections · 2 tables · 15 flashcards · 2 min

Topic 13 of 61 in the MU Sofia syllabus for Obstetrics and Gynaecology (Dental Medicine, Year 4). The free AceMed note covers it in 3 sections, about 132 words (2 min of reading), with 15 flashcards.

In this note

  1. Introduction
  2. Normal changes
  3. Care of the woman after birth

Introduction

The puerperium is the 6 weeks after delivery of the placenta, during which the body returns to its non-pregnant state, except the breasts, which start lactation.

Care of the woman after birth

  • First 1–2 hours: pulse, BP, uterine tone, bleeding, bladder (urinary retention is common).
  • Daily: temperature, uterine involution, lochia, perineum, breasts, legs (calf pain, swelling), mood.
  • Early mobilisation, good hydration; perineal hygiene; analgesia (paracetamol, ibuprofen).
  • Thromboprophylaxis with LMWH when there are risk factors (caesarean section, obesity, age > 35, immobility).
  • Anti-D immunoglobulin within 72 hours if the mother is RhD-negative and the baby RhD-positive.
  • Rubella vaccine if not immune; contraception advice; support breastfeeding.
  • Check at 6 weeks: recovery, mood, BP, contraception, cervical screening if due.

Mood after birth

A uterus that is not involuting, with offensive lochia and fever, means endometritis or retained products until proven otherwise.

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