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OBSTETRICS > 1F - The Puerperium > Flashcards

1F - The Puerperium Flashcards

1
Q

This is the period after delivery of the conceptus?

A

Puerperium

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2
Q

When does puerperium end?

A

6 weeks after the delivery

Starts at 30 mins after delivery of the fetus

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3
Q

How many weeks does it take for the involution of the genital organs to occur?

A

6 weeks

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4
Q

The fundus returns to the level of the umbilicus post pregnancy after how many hours?

A

<24 hrs

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5
Q

Patients who have undergone surgery under general anesthesia within 48 hours should be treated as?

A

Full stomach and receive anti aspiration measures

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6
Q

When does pulse rate return to normal from being elevated post pregnancy?

A

2nd day

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7
Q

A significantly low BP (>20% baseline) post pregnancy could be a sign of what condition?

A

PPH or septic shock

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8
Q

Slightly elevated temperature post pregnancy, if it happens at the 3rd or 4th day, may be caused by?

A

Breast engorgement

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9
Q

Respiratory rate level goes back to normal post pregnancy after how many days?

A

3-4

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10
Q

How much weight is lost post pregnancy?

A

5-6 kg

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11
Q

Why does the uterus undergo involution post pregnancy?

A

To prevent further blood loss

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12
Q

How much does the uterus weigh immediately post partum?

A

1000g

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13
Q

How much does the uterus weigh after 6 weeks post partum?

A

50g

After 1 wk post partum - 500 g

2nd week - 300g

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14
Q

When will the uterus regain its normal non pregnant size?

A

4 weeks

2 weeks - it returns to the pelvic cavity

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15
Q

What are the possible causes of uterine subinvolution? (3)

A

Retained placenta
Uterine infection
Paravaginal hematoma

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16
Q

Lochia can last up to how many weeks post partum?

A

5 weeks

Lochia - vaginal discharge

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17
Q

At the end of complete involution, the internal os returns to its pre pregnay state, T or F?

A

False. It is still wider than before pregnancy

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18
Q

Post pregnancy, the lower uterine segment is converted into?

A

uterine isthmus

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19
Q

This layer of the endometrium becomes the source of new endometrial layer?

A

basal layer

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20
Q

Endometrial regeneration is rapid except where?

A

Placental site

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21
Q

when is the entire endometrium restored post partum?

A

3 weeks

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22
Q

When does complete extrusion of the placental site occur post partum?

A

6 weeks

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23
Q

Stroke volume, heart rate and blood volume post pregnancy, increases or decreases post partum?

A

Increases

*after blood loss

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24
Q

When does cardiac output return to pre pregnant levels after postpartum?

A

2 weeks

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25
SVR decreases during pregnancy and increases back to pre pregnant levels after how nay weeks postpartum?
2 weeks
26
Diastolic blood pressure decreases more than systemic blood pressure during pregnancy, t or f?
True
27
Heart rate after rising from baseline during pregnancy returns to normal after how many weeks?
16 weeks
28
When are the 3 peaks of cardiac output during pregnancy?
At 28 weeks, at labor and immediately postpartum
29
What hormone causes constipation postpartum?
Progesterone Drops within 24 hours. Acid reflux and other symptoms resolve within 3-4 days
30
Pigment changes during pregnancy eventually resolve after how many weeks?
6-8 weeks
31
Striae over abdomen and legs may not disappear even after pregnancy, t or f?
True
32
How many months does it take for hemoglobin levels to return to normal post partum?
4-6 months
33
Hematocrit returns to normal pre pregnant levels after?
3-5 days
34
WBCs return to pre pregnant levels after how many weeks?
4 weeks
35
Pregnancy induced thrombocytopenia after delivery due to blood loss resolves after how many days
4-10 days
36
Hypercoagulable state of pregnancy resolves after how many weeks?
8-12 weeks
37
GFR returns to normal after how many weeks post pregnancy?
8 weeks
38
Lactosuria is generally not good during the start of lactation, t or f?
False. It is normal
39
This is increased in the milk after childbirth to provide increased immune defense?
Colostrum
40
What inhibits prolactin response of breast tissue?
Estrogen and progesterone
41
When does lactogenesis or milk secretion start postpartum?
4th day
42
What action of the baby promotes the synthesis and secretion of oxytocin from the posterior pituitary gland?
Suckling
43
What maintains galactpoiesis?
Oxytocin
44
Besides nutrition, what are other functions of oxytocin postpartum?
Contraception Protection against infection for infant Uterine involution Prevents PPH
45
What condition wherein the pituitary gland forms necrosis can prevent production of oxytocin?
Sheehan syndrome
46
What is the expected blood loss for normal and CS declivery?
Normal - 500ml | CS - 1000ml
47
What is puerperal fever?
=>38 degrees within 2 of the first 10 days or puerperium excluding the first 24 hrs
48
Most common cause of puerperal fever?
UTI
49
What is the characteristic of the fever if the patient experiences metritis with bacteremia and complications?
High grade with chills
50
If pueperial fever last for more than 72 hours even after IV antimicrobial therapy, what condition should be considered?
Parametrial cellulitis or phlegmon
51
What should be done is parametrial abscess forms?
Drainage and excision of necrotic area
52
Where is the usual place of postpartum hematoma?
Under bladder flap or broad ligament Treated with clamping if patient is open or aspiration with sono if closed
53
This is the infection of the fallopian tube?
Salpingitis
54
Adnexal infections postpartum are usually?
Perisalpinigitis
55
Treatment for persistent septic pelvic thrombophlebitis??
Heparin challenge test
56
What organisms cause necrotizing fasciitis?
Grp A strep, staphylococci or polymicrobial
57
If there is suspicion of severe sepsis with or without septic shock, what is the treatment given within one hour?
IV broad spectrum antibiotic
58
If therapies fail in the case of severe streptococcal or staph infection, what is given?
IV Ig
59
What is the treatment for MRSA?
Vancomycin or Teicoplanin
60
A patient with an enlarged and softer uterus postpartum may be at risk of what condition?
PPH due to uterine subinvolution
61
What could cause uterine subinvolution?
Retained placental products and infection
62
What is the initial treatment for late postpartum hemorrhage?
Oxytocin, ergotamine and prostaglandins
63
If PPH recurs or persists after initial treatment, what treatment may be considered?
Curettage
64
A mother after delivery experiences urinary retention, what nerve may have been damaged?
Pudendal nerve
65
An indwelling catheter is placed on the mother's bladder post delivery to avoid urinary retention, how many hours is it placed?
12 hrs
66
During prolong catheterization, what is given for prophylaxis?
Prophylaxis antibiotics
67
If a mother, after delivery, does not breastfeed for 2 or more days post delivery, what condition could arise?
Breast engorgement
68
What breast problem could arise if latch on and positioning toward the breast is improper?
Fissure Breast pump until healed
69
What is the usual cause of mastitis?
S aureus
70
This is postpartum psychiatric illness peak at the 4th or 5th day postdelivery and last for several days but spontaneously remit within the first 2 weeks postpartum?
Postpartum blues Occurs in 85% of women No specific therapy
71
This condition is more persistent and debilitating than postpartum blues and often interferes with the mothers ability to take care of t he child?
Post partum depression Tx - psychotherapy or pharmacological (ssris) *6-12 mos. - first time
72
This is the most severe form of postpartum psychiatric illness?
Postpartum psychosis
73
A patient has delusions against her baby postpartum that she thinks the baby is the son of Satan, what is the condition of the mother?
Postpartum psychosis - psychiatric emergency
74
How do we treat postpartum psychosis?
Inpatient treatment
75
What psychiatric disorder predisposes the mother to postpartum psychosis?
Bipolar disorder

OBSTETRICS (36 decks)

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