introduction anatomy and physiologic changes-UTERUS: At the end of third stage of labour, the uterus is in the midline , about 2cm below the level of umbilicus and weight 1000g

1. PUERPERIUM

5. ANATOMIC AND PHYSIOLOGIC
CHANGES
• UTERUS: At the end
of third stage of
labour, the uterus is
in the midline , about
2cm below the level
of umbilicus and
weight 1000g

12. Vagina
• The greatly distended,
smooth walled vagina
gradually returns to its
pre pregnancy size by 6-
10 weeks after childbirth.
• It regains its tone but
never to the virginal
state.
• Rugae partially reappear
at 3rd week but never to
the same degree as in
prepregnant state.

13. Introitus remains permanently larger than
the virginal state

14. • The reduced estrogen levels also responsible
for causing a decreased amount of vaginal
lubrication, so localized dryness and
dyspareunia may persist until ovarian function
returns and menstruation resumes.