Changes in Uterine Vessels

Blood vessels are obliterated by hyaline changes and replaced by new, smaller vessels.

Lochia is decidual tissue that contains erythrocytes, epithelial cells, and bacteria. See Table 7-1.

When involution is defective, late puerperal hemorrhage may occur.

At the completion of involution, the cervix does not resume its pregravid appearance:

Before childbirth, the os is a small, regular, oval opening.

After childbirth, the orifice is a transverse slit.

The uterine isthmus is located between the uterine corpus above and the internal cervical os below.

All postpartum women who cannot void should be promptly catheterized.

What causes fluid retention postpartum?

High estrogen levels in pregnancy ^ fluid retention

Increased venous pressure in the lower half of the body during pregnancy ^ fluid retention

TABLE 7-1. Lochia



When Observed

Lochia rubra

Red due to blood in the lochia

Days 1-3

Lochia serosa

More pale in color

Days 4-10

Lochia alba

White to yellow-white due to leukocytes and reduced fluid content

Day 11 ^

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