FINAL

Question 1

Postpartum blues

baby blues

Answer 1

Characterized by tearfulness, anxiety, irritation, and restlessness occurring about 3 days after childbirth and usually fading within 1-2 weeks. (Lowdermilk 10 days)

Question 2

Signs and Symptoms “BABY BLUES”

Answer 2

• General irritability
• Weepiness
• Feeling down

Question 3

PP depression

Answer 3

Lasting more than the first 14 days following birth, worsening symptoms

Question 4

To diagnose postpartum depression, the following criteria must be met:

Answer 4

1. Symptoms persist for more than 2 weeks

2. Depressed mood or lack of interest in pleasurable activities (must occur much of the day, almost every day)

Question 5

At least four of the remaining symptoms must be present: (PP Depression)

Answer 5

Depressed mood 
Agitation 
Fatigue 
Lack of interest in pleasurable activities 
Poor concentration and decision making 
Poor appetite 
Insomnia 
Feelings of failure as a mother 
Guilt 
Unusual worry over infant's health 
Suicidal thoughts

Question 6

Treatment for PP Depression

Answer 6

Increasing comprehensive coping methods:
Sleep
Nutrition
Exercise
Social support system
Counseling with a therapist specializing in perinatal mental health

Question 7

PP Psychosis onset

Answer 7

Onset is very sudden usually occurs in first 4 weeks pp.

Question 8

Signs & Symptoms of PP Psychosis

Answer 8

1. Bizarre behavior
2. Disorganization of thought
3. Hallucinations - Delusions(strange beliefs)
4. Decreased need for sleep/Hyperactive
5. Significant mood changes with poor decision making/Irritation

Question 9

PP hemorrhage

Answer 9

Vaginal: > 500ml
C-section: > 1000ml
*blood loss enough to cause hemodynamic instability

Question 10

Primary PPH

Answer 10

first 24 hours PP

Question 11

Secondary PPH

Answer 11

24hrs - 2 wks PP

Question 12

PostPartumHem: 4 T’s

Answer 12

1. Uterine Atony
2. Trauma to Birth canal
3. Reterntion of fetal placenta
4. Thrombin Disorder/Coagulopathy

Question 13

PPH Risk factors (8)

Answer 13

1. prolonged labor
2. grandmultipara
3. augmented labor
4. precipitated labor
5. Hx of PPH
6. overdistended uterus (macrosomia, twins, polyhydramnios)
7. operative delivery
8. chorioamnionitis

Question 14

Other causes PPH (6)

Answer 14

1. unrepaired lacerations of BC
2. Placental abruption
3. placenta previa
4. Mag sulfate admin (intrapartum or PP)
5. ruptured uterus
6. coagualtion disorders

Question 15

Number 1 cause of Primary PPH?

Answer 15

Uterine Atony

Question 16

Number 1 cause of Secondary PPH

Answer 16

Sub-involution (tissue/placenta retention)

Retained products of conception of infection

Question 17

Manage PPH…(5 steps)

Answer 17

1. Massage THE FUNDUS
2. Admin Pitocin
3. Admin Cytotec (Methergine, Hemabate)
4. VS Q 5 min
5. Empty bladder (foley catheter/bedpan)

Question 18

When is Methergine counter-indicated?

Answer 18

hypertension

Question 19

When Hemabate counter-indicated?

Answer 19

Hx of Asthma

Question 20

Moms at risk for PP psychosis

Answer 20

People with a hx of Bipolar are more at risk

Psychiatric emergency due to risk of suicide or fetal harm; 5% infanticide/suicide rate with psychosis