SECTION 2: THE CLINICAL MANIFESTATIONS OF PUERPERIUM

1. Vital sign

1.1 Temperature The body temperature of postpartum is in the normal range. Due to prolonged labor causing fatigue, the temperature will increase slightly in 24 hours after delivery, This is usually not more than 38⋆ C. Lactation fever may appear 3-4 days postpartum.

1.2 Pulses in the normal range.

1.3 Breathing: Thoracic breathing changes to abdominal breathing: slow deep breathing, 14-16 / min.

1.4 Blood Pressure Change is not much. For the parturient with pregnancy-induced hypertension syndrome there is a significant decrease.

2. Involution of uterus

On the first day after delivery, the fundus of theuterus is the level of the umbilicus. Thereafter the fundal height declines by 1-2 cm every day. The uterus becomes a pelvic organ around ten days after the birth.

3. After pains

After delivery the uterus contracts intermittently. This gives rise to pains, similar to but milder than labor pains. This usually subsides 3-4 days after birth.

4. Lochia

This discharge from the uterus in the postpartum period is known as lochia.

4.1 Lochia rubra: is the bright red, copious discharge which starts from delivery and continues for about 3- 4 days postpartum. This consists of blood and sloughed deciduas.

4.2 Lochia serosa:is the lochial discharge for the next 2-3 weeks. This is pale, thinner, slightly blood stained and copious. Plenty of necrotic decidua is seen under the microscope. Both lochia rubra & serosa, have a unique offensive mildly fishy odour.

4.3 Lochia alba: is the yellowish white discharge consisting of leukocytes and exudates. This continues for 3-6 weeks after delivery.

（刘琼 李华）