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After birth, the fundus contracts downward into the pelvis one centimeter each day. After two weeks the uterus will have contracted and return into the pelvis. [9] The sensation and strength of postpartum uterine contractions can be stronger in women who have previously delivered a child or children. [10]
As the uterus returns to its nonpregnant size, its muscles contract strongly, which can cause pain. Fundal massage can be performed with one hand over the pubic bone, firmly massaging the uterine fundus (the top of the uterus), or with the addition of one hand in the vagina compressing the two uterine arteries.
The uterine height is greater than the normal for the particular day of puerperium.Normal puerperal uterus may be displaced by a full bladder or a loaded rectum.
An atonic uterus can feel soft, "boggy" and/or enlarged. [2] Bleeding from the cervical os is also common. If the atony is localized to one area of the uterus, the upper, fundal region may still be squeezing while the lower uterine segment is non-functional. This can be difficult to see with a cursory abdominal examination and easily overlooked.
Leopold maneuvers are difficult to perform on obese women and women who have polyhydramnios. The palpation can sometimes be uncomfortable for the woman if care is not taken to ensure she is relaxed and adequately positioned. To aid in this, the health care provider should first ensure that the woman has recently emptied her bladder.
Postpartum infections; Other names: Puerperal fever, childbed fever, maternal sepsis, maternal infection, puerperal infections: Streptococcus pyogenes (red-stained spheres) is responsible for many cases of severe puerperal fever.
The second two levels form a taxonomy in which each intervention is grouped into 27 classes, and each class is grouped into six domains. An intent of this structure is to make it easier for a nurse to select an intervention for the situation, and to use a computer to describe the intervention in terms of standardized labels for classes and domains.
Fundic gland polyposis is a medical syndrome where the fundus and the body of the stomach develop many fundic gland polyps. The condition has been described both in patients with familial adenomatous polyposis (FAP) and attenuated variants (AFAP), and in patients in whom it occurs sporadically. [1]