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Reproductive - Childbirth > Normal Puerperium > Flashcards

Normal Puerperium Flashcards

1
Q

Why is immediate cord clamping after delivery not recommended?

A

Reduces the red blood cells that an infant receives by more than 50%

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2
Q

With delayed cord clamping, there is a higher red blood cell flow to vital organs in the first week - what effects does this have?

A

Less infant anaemia at 2 months and increased duration of early breastfeeding

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3
Q

Delayed cord clamping should be carried out unless what is necessary?

A

Immediate resuscitation

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4
Q

Cord clamping should be delayed by how long after delivery?

A

3 minutes

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5
Q

What are the advantages of skin-skin contact after birth?

A

Keeps the baby warm and calm and is thought to improve transition to life outside the womb

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6
Q

What is the current recommendation for skin-skin contact after birth?

A

Uninterrupted skin-skin contact for 1 hour following birth

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7
Q

Expulsion of the placenta usually occurs how long following birth? Up to when would be considered normal?

A

5-10 minutes / 30 minutes

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8
Q

What are some signs of placental separation in the 3rd stage of labour?

A

Uterus contracts, hardens and rises / umbilical cord lengthens / gush of blood occurs (variable in amount)

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9
Q

What is placental separation?

A

The placenta separates at the spongey layer of the decidua basalis due to shearing force

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10
Q

What is the major advantage of active management of the third stage of labour?

A

Reduces risk of PPH by 60%

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11
Q

What drugs are used to actively manage the 3rd stage of labour?

A

Uterotonic drugs which increase uterine muscle tone

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12
Q

What are the two ways that uterotonic drugs can be given in the active management of 3rd stage?

A

10U oxytocin IM alone or 5U oxytocin with 500microgram ergometrine IM (Syntometerine)

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13
Q

Both ways of giving uterotonic drugs are equally effective at what?

A

Reducing risk of PPH > 1l

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14
Q

What is the a) advantage and b) disadvantage of using Syntometerine over oxytocin alone as active management of the 3rd stage?

A

a) Better at reducing small haemorrhages b) side effects include nausea and vomiting

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15
Q

Apart from uterotonic drugs, what are some other ways of actively managing the 3rd stage of labour?

A

Cord clamping and cutting, controlled cord traction and bladder emptying

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16
Q

What is a normal blood loss in delivery? What would be abnormal? What would be significant?

A

< 500mls / > 500mls / > 1l

17
Q

If there is any blood loss in labour apart from the initial ‘show’ what should be done?

A

Referral to a consultant led unit

18
Q

What is the puerperium and how long does it last?

A

A period of repair and recovery, the return to a non-pregnant state which takes around 6 weeks

19
Q

What is lochia? How long does it last?

A

Vaginal discharge containing blood, mucus and endometrial castings / lasts 4-6 weeks

20
Q

What type of vaginal discharge is seen 3-4 days after delivery?

A

Rubra (fresh blood)

21
Q

What type of vaginal discharge is seen 4-14 days after delivery?

A

Serosa (brownish-red, watery blood)

22
Q

What type of vaginal discharge is seen 10-20 days after delivery?

A

Alba (yellow)

23
Q

In a non-breastfeeding woman, when does menstruation begin following delivery?

A

Around 8 weeks

24
Q

Why is menstruation delayed in women who are breastfeeding?

A

Prolactin inhibits FSH production and prevents ovulation

25
Q

When after delivery does the uterus begin to return to its non-pregnant state?

A

Immediately after delivery of the placenta

26
Q

What happens in uterine involution?

A

Shortening of muscle fibres and death of excess myometrial cells

27
Q

The fundal height returns from umbilical to pelvic after how long?

A

2 weeks

28
Q

Failure of involution can be caused by what?

A

Retained placental fragments and infection

29
Q

What are some areas of the body which never return to their pre-pregnancy state?

A

Cervix, vagina and perineum

30
Q

What happens to the decidua after delivery?

A

It is shed and replaced with new endometrium

31
Q

What does breast milk provide babies with?

A

Passive immunity and nourishment

32
Q

What initiates lactation?

A

Expulsion of the placenta and a reduction in oestrogen and progesterone

33
Q

When do the breasts become capable of producing milk? Why does this not happen?

A

20 weeks of pregnancy, but is inhibited by progesterone and oestrogen inhibiting prolactin

34
Q

What is colostrum?

A

A thick, yellow fluid produced in the first few days of the baby’s life

35
Q

What is found in colostrum?

A

Immunoglobulins and growth factors to mature the gut

Reproductive - Childbirth (9 decks)

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