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Uterus
Description
The uterus changes radically during pregnancy and puerperium.
Size and Weight Decrease
Immediately after childbirth, the uterus contracts, becoming round and hard.
Two weeks after childbirth, the uterus recedes back into the pelvis (involution).
The weight of the uterus immediately after childbirth is 35 oz. (1000 gm). It shrinks to 17.5 oz. (500 gm) after 1 week, 10.5 oz. (300 gm) after 2 weeks, and approximately 2-2.5 oz. (60-70 gm) after 6 weeks.
The uterine neck, which opens to 10 cm, recovers to near normal, but it is thicker and the endocervix is looser.
Endocervix
The endometrium recovers in 3 weeks. In 6 weeks, the spot where the placenta was attached heals and normal endometrium tissue grows.
The placenta separates and easily leaves the body after delivery without scarring, because there is a soft decidual membrane between the uterus and placenta.
If a woman has undergone curettage for abortion, even once, this leaves many scars on the endometrium and can be a hindrance to the next pregnancy.
Lochia
Lochia is the secretion from the uterus after childbirth.
The outside of the decidual membrane, the placenta side, detaches, and the inside, the uterus side, regenerates. Lochia is secretion mixed with blood from the detaching decidual membrane and postpartum uterus.
As the healing continues and bleeds less, the amount of lochia and the amount of blood in the lochia decreases. Little blood will be present in the lochia after a week, and after 2-3 weeks the lochia turns into a yellowish gray color.
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