Puerperium

Question 1

What is the puerperium?

Answer 1

The 6-week period after delivery when the body returns to its non-pregnant state.

Question 2

When does the puerperium typically end?

Answer 2

Around the 6th week postpartum.

Question 3

By how much does the uterus reduce in size during puerperium?

Answer 3

From ~1000 g to 50–100 g.

Question 4

When is the endometrium fully regenerated?

Answer 4

By 16 days postpartum.

Question 5

Does the cervix return to its pre-pregnancy shape?

Answer 5

No, especially the external os — it remains slit-like in multiparas.

Question 6

What happens to the vaginal mucosa post-delivery?

Answer 6

It becomes less vascular and oedematous by 3 weeks.

Question 7

When is vaginal epithelium restored?

Answer 7

By 6–10 weeks.

Question 8

How early can ovulation return in non-lactating women?

Answer 8

As early as 27 days.

Question 9

What hormone suppresses ovulation during breastfeeding?

Answer 9

Prolactin.

Question 10

What is lochia?

Answer 10

Vaginal discharge post-delivery representing uterine shedding.

Question 11

What are the three stages of lochia?

Answer 11

Lochia rubra, lochia serosa, lochia alba.

Question 12

How long does lochia typically last?

Answer 12

About 5 weeks.

Question 13

What is colostrum and when is it secreted?

Answer 13

The first milk — rich in antibodies, secreted for the first 2–4 days.

Question 14

What hormonal changes trigger lactation?

Answer 14

Drop in oestrogen and progesterone after delivery of the placenta.

Question 15

When do prolactin levels return to normal in non-breastfeeding mothers?

Answer 15

Within 2–3 weeks.

Question 16

What is the most critical clinical priority in the first 2 hours postpartum?

Answer 16

Monitoring for postpartum haemorrhage (PPH).

Question 17

Why is early ambulation encouraged postpartum?

Answer 17

Reduces risk of deep vein thrombosis (DVT).

Question 18

How many extra calories are recommended during the puerperium?

Answer 18

~300 extra kcal/day.

Question 19

What is Anti-D immunoglobulin used for postpartum?

Answer 19

To prevent isoimmunisation in Rh-negative mothers with Rh-positive babies.

Question 20

What is included in basic postpartum exercises?

Answer 20

Pelvic floor, abdominal, leg, and foot exercises.

Question 21

What are the 5 Ts of causes of primary postpartum haemorrhage?

Answer 21

Tone, Tissue, Trauma, Thrombin, Traction.

Question 22

What is the most common cause of secondary postpartum haemorrhage?

Answer 22

Infection (especially endometritis).

Question 23

How is puerperal fever defined?

Answer 23

Oral temp ≥38°C on any two of the first 10 days (excluding day 1).

Question 24

What is puerperal sepsis?

Answer 24

Genital tract infection with ≥2 of: pelvic pain, fever, offensive lochia, subinvolution.

Question 25

List three risk factors for puerperal sepsis.

Answer 25

Anaemia, prolonged labour, poor hygiene, retained products.

Question 26

What is the most common cause of puerperal fever in Nigeria?

Answer 26

Malaria.

Question 27

Name two short-term complications of puerperal sepsis.

Answer 27

Septic shock, disseminated intravascular coagulation (DIC).

Question 28

List two long-term complications of puerperal sepsis.

Answer 28

Infertility, intrauterine adhesions (Asherman’s).

Question 29

What are the 6 W’s (causes) of postpartum fever?

Answer 29

Wind (lungs), Water (UTI), Wound, Walk (veins), Woman (breasts), Wonder drugs.

Question 30

What are the most common lactation-related problems?

Answer 30

Cracked nipples, engorgement, mastitis, abscess.

Question 31

Name three urinary issues seen in the puerperium.

Answer 31

Urinary retention, UTI, incontinence.

Question 32

Why is VTE risk increased in the puerperium?

Answer 32

Due to pregnancy-induced hypercoagulable state.

Question 33

What is the most common psychiatric condition postpartum?

Answer 33

Puerperal (postpartum) blues.

Question 34

What nerve injury causes foot drop after delivery?

Answer 34

Obstetric palsy (lumbosacral trunk injury).