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Puerperium and Lactation - Coggle Diagram
Puerperium and Lactation
Puerperium
Reproductive tract returns to nonpregnant conditions so it can become pregnant again
Major events
Endometrial repair
Vasoconstriction
Maternal caruncle
Necrosis
Leads to sloughing of carunclar mass
Sloughing
Decidual tissue of caruncle into uterine lumen
Repair
Caruncle is covered again with endometrial epithelium
Resumption of ovarian function
Myometrial contractions and expulsion of lochia
Reduction in uterine size and volume
Discharge of fluids and tissue debris from uterus
Minimize hemorrhage
Lochia = blood tinged fluid containing remnants of fetal placenta and endometrial tissue
Elimination of bacterial contamination of repro tract
High phagocytosis due to high estradiol
Postpartum uterine infections
Prolong puerperium
Delay subsequent pregnancies
Prolong uterine involution
Return to estrus is most important factor
Lactation
Synthesis, secretion, and removal of milk from mammary gland
Neonate benefits
Mammogenesis
Development of mammary gland
Mammary ridges
Primary mammary bud
Secondary mammary bud
Canalization
Duct with lumen
Mammary glands arise here in developing embryo
Postnatal changes in mammary gland occur
During pregnancy
Alveoli grow into lobules
Prolactin, ACH, and placental lactogen
Allow mammary epithelium to synthesize milk
During lactation
Provides immunoprotection and nutrition for neonate
Colostrum
Growth of neonate directly proportional to milk protein production
Between puberty and pregnancy
Allometric growth
Disproportionally faster than normal body growth
Increase in prolactin and GH
During involution
Return to nonsecretory state
Lymphocytes and macrophages invade mammary tissue
Between birth and puberty
Isometric growth
Same rate as other tissues
Endocrine mediated
Milk contains hormones and growth factors
Protein hormones
Prolactin, GnRH, GH, TH
Steroid hormones
Estrogen and progesterone
Growth factors high in colostrum
IGF 1&2, EGF, TGF a&b
Peptides derived from milk
15 active peptides
Antihypersensitive
Control blood pressure
Antithrombic
Prevent blood clots
Immunostimulation
Activating immune system
Casomorphins
Inhibit gut motility
Milk ejection
Requires
Neural activation of hypothalamus
Oxytocin release into blood
Sensory activation
Contraction of myoepithelial cells
Mechanical transfer of milk
Alveoli and alveolar ducts
Larger mammary glands
Cisterns
Teat/nipple
Active neuroendocrine reflex
Both
Initiated immediately after parturition
Occur simultaneously for a period of time
