Class 21: Post Partum Flashcards
another name for the post partum period?
peurperium
duration of peurperium period?
6-8 weeks
U/S appearance of postpartum UT?
- large
- hypoechoic
- open int-os
- adnexas not well seen
U/S appearance of endometrium post partum?
- inverted triangle
- fluid
endometrium thickness is __ to __ mm initially; after 10 days, it is __ to __ mm
5-13mm; 3-8mm
post partum uterus measurements?
sag 14.5-25cm
trv 7-14cm
ap 7-10cm
most common lethal complication in post partum?
post partum hemorrhage
what constitutes post partum hemorrhage in vaginal & C-section delivery
blood loss > 500 ml after vaginal
blood loss > 1000 ml after C/S
types of postpartum hemorrhage?
- acute
- delayed
when does acute PP hemorrhage occur?
within 24 hours post delivery
when does delayed PP hemorrhage occur?
2-31 days after delivery
2 causes of acute PP hemorrhage?
- UT atony
- soft tissue damage
what is uterine atony?
when uterus fails to contract after childbirth, blood vessels that were attached to the placenta continue to bleed freely. leads to acute PP hemorrhage
3 types of treatments for uterine atony
- manual massage
- IV oxytocin
- blood transfusion with surgery
how does uterine atony look in US?
normal post partum uterus
cause of uterine atony?
weak myometrium
2 causes of delayed postpartum hemorrhage?
- subinvolution of uterus
- retained secundines
what is subinvolution of uterus?
uterus fails to regress in size
US appearance & tx of subinvolution of uterus is the same as uterine atony. T/F?
true
when is a peurperal infection suspected?
body temperature increases 2 degrees on any 2 of the 1st 10 postpartum days
most common route for puerperal infection?
vaginal
what is ovarian vein thrombophlebitis (POVT)
inflamed ovarian vein due to thrombus
which ovarian vein is more likely to have POVT? why?
ROV dt physiologic torsion of UT after delivery
POVT is related to ___ triad
virchow’s
3 factors for virchow’s triad?
- hypercoaguability of blood
- venous stasis/pooling
- altered vein walls
modality of choice for POVT?
CT & MRI
2 treatments for POVT?
- antibiotics
- anticoagulation treatment
2 c-section complications
- bladder flap hematoma
- wound infection
what is bladder flap hematoma?
blood collection in vesicouterine space
3 signs of a wound infection after c-section
- abscess
- hematoma
- seroma
what is a seroma?
fluid collection under skin surface usually at the c-section incision site
