NORMAL

PUERPERIUM

Dr. Neetu Singh Sulemani

BHMS, MD(Hom)
Professor HOD
Deptt Obs & Gyn
MNHMC&RI
Bikaner
 PHYSIOLOGICAL
CONSIDERATION OF
INVOLUTION OF UTERUS
• MUSCLES - The number of muscle fibres is not
decreased but reduction in myometrial cell size.
• Blood Vessels - Changes most marked at placental
site. Arteries are constricted and new blood vessels
grow.
• Endometrium - Regeneration starts by 7th day and is
completed by day 10. Endometrium is restored by
day 16 except at placental site which takes 6 weeks.
 INVOLUTION OF OTHER PELVIC
STRUCTURES
• Vagina - although distensible it takes 6 to 10
weeks to regain its tone. Mucosa remains
delicate and venous congestion takes
considerable time to subside. Rugae partially
appear at 3rd week while introitus remains
permanently larger.
• Broad & Round ligaments and Pelvic floor &
Pelvic Fascia require considerable time to
recover from the stretching effect.
 LOCHIA

• Vaginal discharge for the first fortnight (2

weeks) during puerperium.

• Odour - Offensive fishy smell

• For a Woman who is exclusively breast
feeding, the contraceptive protection is about
98% up to 6 months postpartum
• lactation provides a natural method of
contraception.
• However ovulation may precede the first
menstrual period in 1/3rd women and it is
possible for the woman to become pregnant.
POSTNATAL CARE