Obstetrics- Postpartum & breast feeding

Question 1

Post-partum Blues

Answer 1

Self limiting, mild depression that starts 2-3 days after birth. Symptoms peak 5 days and resolve by 14 days. Increased risk for postpartum depression

Question 2

Tx. post-partum blues

Answer 2

Reassurance and monitoring if symptoms don’t resolve in 2 weeks treat depression

Question 3

Preferred antidepressant in breastfeeding mothers

Answer 3

Sertraline- neglige levels in breast milk

Question 4

S&S Post partum blues

Answer 4

Mild depression:
Irritability
Tearfulness 
Dysphoria
Anxiety 
Insomnia
Impaired concentration

Question 5

Post-partum depression

Answer 5

Onset 4-6 weeks postpartum (but can occur up to 1yr) ≥2 wks of moderate to severe depression.

Question 6

Mechanism of amenorrhea white breastfeeding

Answer 6

Lactation amenorrhea is the result of high levels of prolactin which has an inhibitory effect on the production of the hypothalamic gonadotropin-releasing hormone. There by blocking production of lh and Fsh and suppressing ovulation

Question 7

Amniotic fluid embolism syndrome

Answer 7

Amniotic fluid enters maternal circulation through areas of disrupted maternofetal connections (Endocervical veins, Areas of uterine trauma) and initiates wide spread inflammatory response

Question 8

S&S amniotic fluid embolism syndrome

Answer 8

Hypoxic respiratory failure 
Obstructive shock 
Pulmonary edema
Cardiovascular collapse
Coma/ Seizure 
DIC

Question 9

Management amniotic fluid embolism syndrome

Answer 9

Intubation & mechanical ventilation
Vasopressors
Massive Transfusion

Few survive.

Question 10

Postpartum urinary retention

Answer 10

Inability to void ≥6hrs after vaginal delivery due to neural axial anesthesia and pudendal nerve injury.

Question 11

Diagnosis postpartum urinary retention

Answer 11

Urinary catheterization both diagnostic and tx. Volume ≥150ml.

Question 12

Tx post party urinary retnetion

Answer 12

self limiting. most regain function after catheterization