OB - Module 7 Flashcards
When does involution begin?
Immediately after birth to control bleeding and return organs to normal size
What stimulates contractions in the mother?
Oxytocin
3 stages of lochia
Rubra(1-3 days), Serosa (4-10), Alba (up to 6 weeks)
How long does the vagina take to heal?
6 weeks. does not return to pre-pregnancy size. Painful intercourse for 4-6 months
Volume for Post partum hemorrhage
500ml Vaginal, 1000mL Cesarean. Before 24 hours (early), After 24 hours (late)
What are the most common causes of Postpartum hemmorhage?
Uterine atony and trauma
Management of uterine atony (boggy fundus)
Fundal massage and empty bladder
placenta accreta
placenta grows into uterine wall causing continuous bleeding
What medications are given for postpartum hemorrhage?
Pitocin, methergine, and prostaglandin
First vital signs for hemorrhage
Tachycardia, reduced blood pressure
Laceration
Fundus is firm and in expected position, but bleeding is continued.
Signs of hypovolemic shock
Tachycardia, pale cool skin, decreased pulse pressure, increased respirations
What causes subinvolution of the uterus?
Retained placental pieces and infection
Normal ways the postpartum woman gets rid of fluids
Diuresis and Diaphoresis
What increases to protect the mother from hemorrhage?
Fibrinogen and Clotting factor
How much urine output could a postpartum mother have?
3000ml per day is not uncommon
SVT/DVT management
Bedrest, elevated legs, analgesics, anticoagulants
Sign of SVT
Obvious inflammation. reddening, swelling. Diagnosed with patient’s symptoms.
Sign of DVT
Pain on ambulation, diagnosed with doppler
Blood values for postpartum
Increased WBCs and Neutrophils
Low hematocrit
How do the muscles look?
Stretched and decreased tone
How does the skin look?
hyperpigmentation (dark skin spots), stretch marks, and hair loss for 3-4 months
When does ovulation/menstruation begin again?
Non breast feeding: 7-9 weeks
Breast feeding: 12 weeks - 18 months
Still need to use contraceptives
Metritis
Infection of the lining of the uterus
