Puerperium

introduction
anatomy and physiologic changes-UTERUS: At the end of third stage of labour, the uterus is in the midline , about 2cm below the level of umbilicus and weight 1000g

1. PUERPERIUM

2. ANATOMIC AND PHYSIOLOGIC CHANGES UTERUS: At the end of third stage of labour, the uterus is in the midline , about 2cm below the level of umbilicus and weight 1000g

3. Vagina The greatly distended, smooth walled vagina gradually returns to its pre pregnancy size by 6-10 weeks after childbirth. It regains its tone but never to the virginal state. Rugae partially reappear at 3rd week but never to the same degree as in prepregnant state.

4. Introitus remains permanently larger than the virginal state

5. The reduced estrogen levels also responsible for causing a decreased amount of vaginal lubrication, so localized dryness and dyspareunia may persist until ovarian function returns and menstruation resumes.