The Early postpartum haemorrhage period

Postpartum period

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The postpartum period, puerperium, begins with the departure of the afterbirth and ends after the disappearance of all reversible changes that have occurred in the sexual apparatus and throughout the woman's body during pregnancy and childbirth.

The postpartum period (the puerperal period) begins with the expulsion of the afterbirth and lasts 6-8 weeks. During this period, reverse development occurs (involution) of organs and systems, except for the mammary glands, which underwent changes due to pregnancy and childbirth. Particular attention should be paid to the early postpartum period (the first 2-3 hours after delivery), when such formidable complications as bleeding from the genital tract, birth shock (see Postpartum diseases ) are possible. During this time the puerpera should be in the birth room under the constant supervision of the midwife.

The postpartum period is characterized by a number of processes throughout the body; the most significant of these are the involution of the uterus and the beginning of the secretory function of the mammary glands. After birth the bottom of the uterus when the bladder is emptied is at the level of the navel ; then the bottom of the uterus descends daily approximately 1 cm and on the 10th-12th day is at the level of the pubic articulation. The cervix is ​​formed from the inside outwards: the inner pharynx closes by the 7th-10th day, and the outer cervix closes on the third week after birth. Discharge from the uterus (lochia) in the first days of bright red color, from the 3rd day to brownish red, from 7th to 8th day - yellowish, and from the 10th day - light; by the 20th day the plains disappear.


Important parameters of the postpartum period are the body temperature and the pulse of the puerpera, which must be noted daily on a temperature sheet . As a rule, after physiological birth, the body temperature is normal, except for two observed occasions of ascent - 12 hours after birth to 37.5-37.6 ° and on the third day to 37.5-37.9 °, which is due to suction from the uterus of its contents; the pulse is full, even, often slowed down to 60 and 50 beats per minute. Rodilnitsy (more often mimicking) at feeding sometimes complain of painful contractions; in these cases, you can use antipyrine or amidopirin (pyramidone) , phenacetin (0.3-0.5 grams). In the postpartum period, there may be a delay in urination (with the overflowing bladder displacing the uterus upward) and in the first two days the stool retention; hemorrhoidal nodes may appear, since the hemorrhoidal veins at the end of pregnancy have been enlarged. With a delay in urination, you can put a bladder with warm water on the bottom of the stomach, the mother can sit down. In the absence of a chair, a cleansing enema is placed on the third day after delivery.

In the postpartum period, due to the existing wound surface in the uterus and often on the perineum, there is a danger of infection of the parturient woman. During this period it is very important to organize the care. The chamber for puerperas should be systematically ventilated. Bed linen should be clean and well ironed. On the middle third of the sheet should be put on an oilcloth, on it small nappies lie. They change at each toilet of the parturient, which consists in the washing of the external genital organs and in the bed rest. The toilet is administered 4 times a day for the first 2 days, and then until it is issued 2 times a day. With a toilet under the pelvis of the puerperas, a bedpan is laid, then, pouring from a mug of Esmarch or a jug with a warm weak solution of potassium permanganate , the external genitals are washed with a cotton stupor on a long corncang, while the movements are made from the top down. After washing, the pubis and external genitalia are drained with dry sterile cotton wool; the area of ​​the anus is drained by the latter.

After the physiological birth and during the normal course of the postpartum period, the puerpera on the second day may get out of bed. Food in the postpartum period should be high-calorie with a lot of vitamins.