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What common term is used to describe the six-week period after the delivery of an infant?

A. Prenatal

B. Fourth quarter

C. Perinatal

D. Postpartum

D. The postpartum period is classically defined as the 6 weeks after the delivery of the infant. It is also referred to as the puerperium, derived from the latin, puer, meaning "child," and pario meaning "to bring forth".

A. Prenatal meaning 'before birth' represents the time prior to giving birth.

B. The terminology of fourth quarter is incorrect. Now termed, the "fourth trimester," the American College of Obstetricians and Gynecologists recommend that postpartum care should become an ongoing process, rather than a single encounter, with services and support tailored to each woman's individual needs.

C. Perinatal is often referred to as the range of time when a patient becomes pregnant and up to a year after giving birth.

Which of the following physiologic changes are seen in the postpartum period?

A. Increase in cardiac output by as much as 80%

B. Immediate decrease in size of the kidney and collection system by 6 hours after delivery

C. Decrease in uterine vascular resistance resulting in increased uterine blood flow up to 1200 mL/min

D. Increase in uterus anterior/posterior diameter by over 50%

A. An enormous increase in cardiac output, upwards of 80%, is seen in the immediate puerperium period with prelabor values seen 1 hour following delivery.

B. The renal system returns to its pre-pregnant state by 6 weeks after delivery, with a return to normal renal plasma flow, creatinine clearance, and glomerular filtration rate. The actual size of the kidney and collection system may take longer to return to pre-pregnant values.

C. Using pulsatility index to look at uterine blood flow, Tekay and colleagues were able to demonstrate a significant increase in uterine vascular resistance by day 2 postpartum. This corresponds to the decrease noted in uterine blood flow immediately postpartum.

D. In an ultrasound study by Mulic-Lutvica and colleagues, the anterior/posterior diameter of the uterus was the greatest (~ 9 cm) on the day of delivery and decreased to 3-4 cm by day 56. The uterus returns to the pre-pregnancy size in approximately 6-8 weeks.

According to the American College of Obstetricians and Gynecologists recommendations, when should postpartum care planning begin and when should a comprehensive postpartum visit occur, respectively?


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