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45 Cards in this Set
- Front
- Back
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What is the puerperium?
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The time from delivery until 6-12 weeks after delivery.
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What are the five potential pathways of milk production in the alveolus?
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1. Excodytosis for milk protein and lactose in golgi-derived secretory vesicles.
2. Milk fat secretion via milk fat globules (apocrine secretion) 3. Secretion of ions and water across the apical membrane 4. Pinocytosis/exocytosis of Ig's. 5. Paracellular pathways for plasma components and leukocytes. |
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How does prolactin affect ovulation?
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Prolactin surges suppress LH, thereby inhibiting ovulation.
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What is the most important galactokinetic hormone?
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Oxytocin.
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What does oxytocin do?
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It appears to direct regional blood flow.
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What is the main source of energy for milk production?
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Glucose
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What is the main source of carbon as a substrate for milk production?
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Glucose
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Does starvation alter breast milk composition?
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No
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How does a mother's diet change while breast-feeding?
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1. Consume 800 kcal/day more
2. Increase vitamins/minerals 20-30% 3. Extra liter of fluid/day needed |
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What are some benefits of breast feeding?
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1. Children have less obesity and long-term health problems
2. Children resist infection |
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How does breast milk contribute to resisting infection?
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1. Breast milk contains high quantities os sIgA
2. Colostrum has high [sIgA] 3. Macrophages and T-cells trsferred to neonatal gut via breast milk 4. Breast milk has high [lactoferrin]; makes iron unavailable to pathogenic bacteria. |
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What drug can be used to suppress lactation?
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Bromocriptine; no longer used b/c caused stroke, seizures, and MI.
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When does the uterus return to its normal size?
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Within 6 wks of delivery.
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What are histologic changes of the uterus in the first 3 days after delivery?
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The placental site infilitrated w/ granulocytes and mononuclear cells. Lasts 10 days presumably serves as inflammatory barrier against microbes.
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What are histologic changes of the uterus during the 7th day after delivery?
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Endometrial gland and stroma begin to regenerate.
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When is the endometrium fully restored after delivery?
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By the 16th day after delivery.
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What is lochia?
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Uterine discharge after delivery.
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What is lochia rubra?
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Uterine discharge the first few days after delivery (the first type of discharge)
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What is lochia serosa?
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Lasts 22 to 27 days (the second type of discharge)
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What is lochia alba?
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It may last several weeks.
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When does the cervical epithelium regress?
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Within 4 days.
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What happens to the cervix by day 7?
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Edema and hemorrhage are minimal.
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When is involution of the cervix complete?
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By 6 weeks.
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When does ovulation resume in non-lactating women?
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70 to 75 days (2.5 months)
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When does ovulation resume in lactating women?
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6 months
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When does menses return in non-lactating women?
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12 weeks (3 months)
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When does menses return in lactating women?
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36 months
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What mediates puerperal ovarian suppression?
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Elevated prolactin levels
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When does venous tone return?
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6 weeks postpartum
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How long does CO remain elevated in women?
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Up to 1 year after delivery
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When does fibrinolytic activity increase?
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In the first week postpartum, but rapidly returns to normal.
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When is the highest level of coagulability in the woman?
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In the first 48 hours postpartum.
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How long does renal plasma flow stay increased postpartum?
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It begins to decrease during the postpartum period, but can remain elevated for up to 5 years.
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What happens to hair growth during the puerperium?
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It slows; hair loss is common.
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How long should postpartum women stay hospitalized?
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Vaginal delivery = 2 days
Cesarean = 3-4 days |
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How long should pts avoid intercourse?
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For 3-4 weeks (when bleeding has stopped and perineal pain has resolved).
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When can the pt begin progestin-only OC's?
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At time of delivery
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When can depo-provery be administered?
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Immediately postpartum
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What is delayed postpartum hemorrhage due to?
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Eschar sloughing at the placental implantation site ("Subinvolution of the placental site")
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What defines postpartum infection?
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A temp > 38 C (100.4 F), or any of the 2 first days after delivery (excluding first 24 hrs)
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What's the most common cause of postpartum infection?
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Endomyometritis
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How do we diagnose mastitis?
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Usually by very high fever (104 F), pain, redness, tenderness, myalgias.
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What usually causes mastitis?
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S. aureus or Streptococcus spp.
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What is maternity blues?
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A transiet state of terfulness, anxiety, irritation, and restlessness. Usu resolves in 2 wks.
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What is postpartum depression?
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Mild psychosis to suicide due to changes in HPA axis & CRH.
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