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1、第七版妇产科-第八章正常产褥(The seventh edition ofObstetrics and Gynecology - the eighth chapter of normalpuerperium)The seventh edition of Obstetrics and Gynecology, the eighth chapter.Txt normal puerperal people never know what to expect of who you say goodbye then really disappeared. How long is a minute? It
2、depends on whether you are sitting on the toilet, or waiting outside the bathroomThe eighth chapter normalpuerperiumFrom the beginning to the delivery of maternal disc of the organs of the body in a period of breast normal or nearly normal non pregnant state required, called the puerperal period (pe
3、qJenum), the general provisions for 6 weeks.The first section changes the puerperium maternal changes, reproductive system(a) Zi Fu1. the process of involution of uterus after delivery of the placenta of the uterus gradually returned to the non pregnant state called uterine involution (involution 0f
4、 ukrIIe). The main performance for the official decorum and endometrial retraction of muscle fiber regeneration.(1) the official decorum of muscle fiber retraction: uterine involution not muscle cell number decreased, but the muscle cells reduced, muscle cellsshowed cytoplasmic protein breaks down d
5、ischarge, the plasma is decreased. Proteins and metabolites excreted through the kidney cracking. With the continuous muscle fiber retraction, uterine body gradually reduced in L weeks postpartum uterus reduced to about 12 weeks of pregnancy in size above the pubic symphysis palpable. In 10 days pos
6、tpartum uterus to pelvic cavity. No palpable abdominal examination official end. Until 6 weeks postpartum. The uterus return to normal non pregnant size. The weight of the uterus decreased gradually. At the end of delivery is about 1000g, l about 500g weeks postpartum 2 weeks postpartum, about 300g,
7、 until 6 weeks postpartum was 50 - 6, slightly larger than the non pregnant uterus.(2) endometrial regeneration: placenta decidua is discharged from the sponge layer after the separation of placental surface immediately reduced to palm, the area is only half of the original, spiral artery and vein s
8、inus compression leads to thrombosis in the narrow, affect the normal coagulation function decreased gradually until the stop bleeding. The wound surface is necrotic, with the evil white vaginal discharge. The remnants of the basal layer of the endometrium regeneration function gradually a new layer
9、 of neointima the uterus slowly repaired in about third weeks postpartum. In addition to the placental site outside the uterine cavity surface by intimal repair. Need to repair all the placental site 6 weeks postpartum, if during placental surface due to thrombosis subinvollution appears, can cause
10、of late postpartum hemorrhage.2. delivery of the placenta after cervical cervical soft, thin wall wrinkled, cervix a ring like cuffs. In 2 - 3 days postpartum, house can through 2. Cervical shape (1 weeks postpartum) and the cervix (10 days postpartum) returned to the non pregnant state 4 weeks post
11、partum cervical completely restored to normal form, only because the cervix childbirth had mild laceration, because in 3 cervical and 9 points, the early maternal cervix by prenatal round (not production type), for postpartum type - transverse (produced type).(two 1.After the birth of the vaginal ca
12、vity expansion, vaginal wall relaxation and low muscular tension, vaginal mucosal folds due to excessive stretch and reduce or even disappear. In the puerperium vaginal cavity gradually reduced, vaginal wall muscle tension recovered gradually, the re emergence of the mucosal folds in about 3 weeks p
13、ostpartum, but the vagina in puerperium can not be fully restored to the end are not pregnant when tension.97-I three) of vulvaAfter the birth of mild edema of vulva, from 2 to 3 days postpartum subside.If you have mild perineal tear or perineal incision after healed in 3 to 5 days. Hymen tear in ch
14、ildbirth incomplete form called carunculae traces.(four) pelvic tissuePelvic floor muscle and fascia, due to excessive expansion of the labor elasticity, and is often accompanied by muscle fiber fracture. If you can insist on doing exercise on postpartum puerperium, pelvic floor muscle may be return
15、ed to close to the non pregnant state, or rarely restitution. If the pelvic floor muscle and fascia of serious fracture caused by pelvic floor relaxation, in addition to puerperal early to participate in heavy physical labor, can cause vaginal wall prolapse, uterine prolapse and even. Two, the chang
16、e of breastThe main change is breast milk. Postpartum breast milk secretion of neurohumoral regulation: with placental abruption complicated discharge, placental lactogen, estrogen and progesterone levels decreased rapidly in maternal blood, placental lactogen in 6 hours away, in a few days after the decline of progesterone and estrogen in 5 postpartum 6 days decreased to baseline. Estrogen increased prolactin pituitary development effects on breast m
