Ante/postnatal care

Question 1

viral infections that do not contraindicate

breastfeeding

Answer 1

• maternal cytomegalovirus infection, both virus
  and antibodies are present in breast milk.
• hepatitis B virus although it is excreted in milk, breastfeeding is not contraindicated if hepatitis B immune globulin is given to the newborns of affected mothers.
• Maternal hepatitis C infection is not a contraindication because breastfeeding has not been shown to transmit infection.
• Women with active herpes simplex virus may suckle their infants if there are no breast lesions and if particular care is directed to hand washing before nursing.
• HIV in poor developing countries where poor nutrients may affect the baby

Question 2

drugs are absolutely contraindicated while breastfeeding

Answer 2

Cytotoxic drugs, Examples include
cyclophosphamide, cyclosporine, doxorubicin, methotrexate, and mycophenolate.
Radioactive isotopes of copper, gallium, indium, iodine, sodium, and technetium rapidly appear in breast milk. Consultation with a nuclear medicine
specialist is recommended before performing a diagnostic study with these isotopes, The mother should pump her breasts before the study and store
enough milk in a freezer to feed the infant. After the study, she should pump her
breasts to maintain milk flow but discard all milk produced during the time that
radioactivity is present. This ranges from 15 hours to 2 weeks, depending on the
isotope used.

Question 3

What is the recommended dose of Vit D during pregnancy?

Answer 3

Vitamin D 10 micrograms daily supplementation is recommended during pregnancy and while breastfeeding.

Further reading CMACE/RCOG Joint Guideline. Management of women with obesity in pregnancy. 2010.

Question 4

Vital signs monitoring postpartum

Answer 4

For 2 hours after delivery, blood pressure and pulse are taken every 15 minutes, at minimum. Temperature is assessed every 4 hours for the first 8 hours and then at least every 8 hours subsequently (FIGO)

Question 5

puerperal fever defined by a

Answer 5

temperature of 38.0°C (100.4°F) or higher.

Question 6

Mytriform caruncles

Answer 6

Scared hymen post delivery represnted by several small tags of tissue.

Question 7

The most common isolated organism in breast infections is

Answer 7

S aureus especially MRSA found in 40 % of women with mastitis