7: PP Complications

Question 1

Temperature greater than 38°C (100.4°F) that occurs on any 2 days (after the first 24 hours) within the first 10 days postpartum.

Answer 1

Puerperal fever

Question 2

Temperature greater than 38°C (100.4°F) that occurs on any 2 days (after the first 24 hours) within the first 10 days postpartum that is caused by an organism.

Answer 2

Puerperal infection

Question 3

Symptoms include persistent elevated temperature of 38°C to 39°C (100.4–102.2°F) or higher depending on the type of infection, along with chills, malaise, tachycardia, uterine tenderness, pelvic pain on examination, scanty, odorless or malodorous, seropurulent lochia, and uterine subinvolution.

Answer 3

Uterine infection

Question 4

A fever spiking to 39°C (102.2° F), abruptly occurring within 24 hours after cesarean birth, may indicate _____ infection.

Answer 4

A fever spiking to 39°C (102.2° F), abruptly occurring within 24 hours after cesarean birth, may indicate GBS infection.

Question 5

2 locations for wound infection.

Answer 5

Vaginal laceration

C-section incision

Question 6

Symptoms include frequency, urgency, low abdominal pain, and dysuria.

Answer 6

UTI

Question 7

Symptoms often include reports of increased, continued bleeding as well as cessation and then return of bleeding.

Answer 7

Uterine subinvolution

Question 8

What would you find on PE with uterine subinvolution?

Answer 8

Subinvolution is noted on examination with presentation of a boggy, larger-than-expected uterus for that time period.

Question 9

What additional s/s would be noted if uterine subinvolution occurred secondary to infection?

Answer 9

Uterine tenderness

Malodorous lochia

Question 10

Signs and symptoms include increased or persistent heavy bleeding, cessation of bleeding followed by its sudden return, and possibly signs and symptoms of hypovolemia or shock.

Answer 10

Secondary PP hemorrhage

Question 11

When is secondary PP hemorrhage most likely to occur?

Answer 11

After the first 24 hours following childbirth and until 12 weeks postpartum (usually within the 1st 2 weeks PP).

Question 12

Your patient calls with complaints of increased heavy bleeding at 7 days PP. What are you thinking?

Answer 12

A sudden, transient episode of increased bleeding, usually 7 to 10 days postpartum, is related to sloughing of the eschar (placental site) and not considered a postpartum hemorrhage.

Question 13

Extravasated blood accumulates.

Answer 13

Puerperal hematoma

Question 14

Signs and symptoms include persistent bleeding despite a firm uterus; increased vulvar, vaginal, or rectal pain and pressure; and presentation of a fluctuant edema with bluish coloration.

Answer 14

Puerperal hematoma

Question 15

Signs and symptoms can include localized extremity pain, a firm cord-like structure, edema, erythema, and warmth at the site.

Answer 15

Venous thrombophlebitis or thromboembolism

Question 16

Often occurs with abrupt onset of severe leg pain, which worsens when ambulating or standing. Generalized edema of the entire leg is present, and the woman may present with a slight temperature and mild tachycardia.

Answer 16

Venous thrombophlebitis or thromboembolism

Question 17

Puerperal _____ usually presents within 24 to 48 hours after birth, and _____ presents after 48 hours and before 4 months postpartum.

Answer 17

Puerperal preeclampsia usually presents within 24 to 48 hours after birth, and late preeclampsia presents after 48 hours and before 4 months postpartum.

Question 18

When does PP thyroiditis usually appear?

Answer 18

Anytime in the first PP year, but usually at 1-4 months.