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(Postpartum care)
Normal Puerperium
Definition
1. It is the period of adjustment after pregnancy and delivery when
anatomical and physiological changes of pregnancy are reversed and
the body returns to the normal non pregnant state.. (reproductive tract
returns to its normal, non-pregnancy state)
Vagina
shrinks to a non-pregnant state
resolution of the increased vascularity and
edema occurs by 3 weeks
the vaginal epithelium appears atrophic.
This is restored by weeks 6-10.
Perineum
Swelling completely gone within 1-2
weeks
The muscle tone may or may not
return to normal, depending on the
extent of injury.
The muscular walls of the pelvic organs
Cold baths
Electrotherapy (TENS)
Pelvic floor exercises (contract relax
technique
Teach the mother the correct defecation
technique
Use of an appropriate cushion when
sitting.
Deep venous thrombosis
Prophylactic treatment:
Early ambulation.
Avoidance of pressure on the thighs and
calves.
Sitting position with knee flexed.
Encouragement of:
Circulatory ex., leg and deep breathing ex.
Management of After Pain
1) Analgesics.
2) TENS.
3) Frequent urination every 2 hours.
4) Heat application.
5) Relaxation on face.
Prone lying position with tow pillows under the pelvis (to keep the back
from hollowing and to stretch the abdominal muscles, small pillow
under feet, the upper limbs extended beside the trunk, head
turned to one side, or the upper limbs crossed with the forehead
rested on the crossed upper limbs
Values of relaxation on face:
It is a relaxed position.
Help involution of uterus.
Help discharge of blood colts and lochia.
Guard against retroversion flexion
Relief after pain
Diastasis of recti abdominal muscles
• It means separation of the rectus abdominal muscles from med-line
at linea alba. It is not hernia.
• It is a gap between the recti muscles 25mm(2.5 fingers)
• Palpated just superior to the umbilicus.
• It may occur during pregnancy after 20 weeks of pregnancy
or expulsive stage of labour due to weakness and increases tension
of abdominal muscles.
Management of diastases
of recti abdominal muscles