The postpartum (puerperal) period is the length of time beginning after placenta delivery and lasting for 6 weeks. During this time all the organs and systems that experienced pregnancyand birth-related changes now undergo involution, with the exception of the mammary glands whose function reaches its peak exactly during the postpartum period. The most pronounced involution changes take place in the genitals, especially in the uterus. The rate of involution changes is most pronounced in the first 8-12 days.
The first pregnancy and delivery usually bring about stable changes that make it possible to establish the fact of previous pregnancy even after a considerable lapse of time (condition of the perineum and vagina, changes in the shape of the cervix and external os, striae gravidarum on the skin).
11.1. CLASSIFICATION
The first 2 hours after delivery are viewed separately; this time period is called early postpartum period. When it is over, late postpartum period begins.
In the English-language publications the postpartum period is usually divided into:
• immediate postpartum period that lasts for 24 hours after delivery. This is the time of complications related to anesthesia or delivery itself;
• early postpartum period that lasts for 7 days after childbirth;
• late postpartum period that lasts for 42 days ending commonly in complete involution of all organs and systems of the puerpera.
The chronologic division into periods is conventional; the division is based on the fact that complications due to disturbed contractile activity accompanied by bleeding most often set in during the first hours after childbirth.
11.2. ANATOMICAL AND PHYSIOLOGICAL CHANGES IN POSTPARTUM PERIOD