Page 269 - كتاب تمريض نسا الاكتروني

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g. Breast feeding may increase lochia.

h. Foul – smelling lochia and scant may indicate an infection.

i. Bright red blood indicates cervical or vaginal laceration.

2) Cervix:

 Immediately after delivery of the placenta the cervix has little tone and

become thicker and firmer.

 The cervix is closed by the end of the first week

 Complete cervical involution may take 3-4 months and childbirth result in a

permanent change in the cervical OS from round to elongated.

 The uterine ligaments involute but subinvolution predisposes to prolapse and

retroversion.

3) Vagina:

 The vagina becomes smooth and swollen with poor tone after delivery.

Vaginal rugae reappear by 3 – 4 postpartum weeks.

4) Perineum:

 The perineum appears edematous and bruised after delivery.

 The perineum regains its tone by the end of puerperium.

5) Vulva:

 Edema, minute, or frank laceration may be seen immediately after labor.

 Edema disappears gradually in a few days while lacerations, if not properly

mended by sutures, may lead to the formation of a postpartum ulcer.

 The gaping of the vulva disappears.

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