Parameters, Investigations and Management of Normal Puerperium Patient

Definition of Normal Puerperium:

Puerperium is the period following child birth during which the body tissues, specially the pelvic organs revert back approximately to the pre-pregnant state both anatomically and physiologically within approximately 6 weeks.

Normal Puerperium
Fig: Normal Puerperium

Duration and Division of Normal Puerperium:

Puerperium begins as soon as the placenta is expelled and lasts for approximately 6 weeks.

Division of Normnal Puerperium:

  • Immediate: Within 24 hours,
  • Early: Up to 7 days,
  • Remote: Up to 6 weeks.

 Parameters of Normal Puerperium:

  1. Pulse-Normal.
  2. Blood pressure-Normal.
  3. Temperature-Normal.
  4. Involution of uterus.
  5. Normal lochial discharge-
  • Lochia rubra (red): 1-4 days
  • Lochia serosa (Yellow): 5-9 days.
  • Lochia alba (whitish): 10-15 days.

Investigations During Normal Puerperium:

  1. Pulse-Normal.
  2. Blood pressure-Normal
  3. Temperature-Normal
  4. Involution of uterus
  5. Normal lochial discharge-
  • Lochia rubra (red): 1-4 days
  • Lochia serosa (Yellow): 5-9 days.
  • Lochia alba (whitish): 10-15 days.


  • RM/E of urine,
  • Blood for Hb%, RBS.

Management of Normal Puerperium Patient:

  • The principles of management:
  • To give all out attention (to restore the health status of mother).
  • Prevention of infection.
  • Care of the breasts (including promotion of lactation and nursing of the child).
  • Motivate the mother for contraception.


1. Immediate attention -Close observation.

2. Rest and ambulance: Early ambulation is encouraged.

3. Hospital stay: For 24 -48 hours and 3 – 5 days in those who have perineal stitches.

4. Diet: High calories, adequate protein, fat, plenty of fluids, minerals and vitamins.

5. Care of the bladder – The patient is encouraged to pass urine following delivery as soon as convenient. If the patient still fails to pass urine catheterization should be done.

6. Care of the bowel -A diet containing sufficient roughage & fluids.

7. Sleep: The patient is in need of rest, bot physical & mental.

8. Care of the vulva & episiotomy wound:

  • Shortly after delivery, the vulva & the buttocks are washed with soap water down over the anus & sterile pad is applied.
  • The nurse should be used sterilized gloves during dressing.

9. Care of the breasts: The nipple should be washed with sterile water before each feeding and it should be cleaned & dry after feeding.

10. Maternal – infant bonding (rooming): This is manifested by fonding, kissing, cuddling and gazing at the infant.

11. Asepsis & antiseptics – (During the first week of puerperium):

  • Liberal use of local antiseptics, aseptic measures during perineal wound dressing, use of clean, bed linen and clothing.
  • Clean surroundings and limited numbers of visitors.

12. Immunization:

  • Anti-D gamma globulin-if Rh. negative mother.
  • Rubella vaccine-if indicated.
  • Booster dose of tetanus toxoid-at the time of discharge.

13. Advice for family planning and contraception.

More questions related to this article:

  1. What is normal puerperium?
  2. What do you mean by normal puerperium?
  3. What is the duration of normal puerperium?
  4. How many divisions of normal puerperium?
  5. What are the parameters of normal puerperium?
  6. What are the investigations you have to do during normal puerperium?
  7. How do you manage a patient of normal puerperium?

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