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OB/GYN > OTHER POSTNATAL COMPLICATIONS > Flashcards

OTHER POSTNATAL COMPLICATIONS Flashcards

1
Q

What is the other term for postnatal infection?

A

Puerperal pyrexia / infection

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2
Q

What is the definition of puerperal pyrexia?

A

Maternal temperature of 38˚C maintained for 4-6 hours in the first 14 days after delivery

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3
Q

What is the most common infection associated with puerperal pyrexia?

A

Endometritis caused by Group A Streptococcus

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4
Q

What is the most common cause of maternal death in the UK?

A

Sepsis

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5
Q

What are the usual sites of infection in postnatal infection?

A 
Uterus
Abdominal incision
Perineum
Chest
UTI
Breast
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6
Q

What are the risk factors for developing endometritis?

A

Caesarian section

Retained products

Manual removal of placenta

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7
Q

What are the symptoms of endometritis?

A

Lower abdominal pain

Foul smelling vaginal discharge

Fever

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8
Q

What are the risk factors for postpartum infection of the perineum?

A

Vaginal tear

Episiotomy

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9
Q

What is the antibiotic of choice for postpartum mastitis?

A

Flucloxacillin

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10
Q

Should a woman being treated for postpartum mastitis continue to breast feed?

A

Yes

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11
Q

What antibiotics should be given for endometritis causing puerperal pyrexia?

A

Clindamycin and gentamicin until afebrile for more than 24 hours

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12
Q

What is the incidence of post-natal depression?

A

Around 10% of women

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13
Q

What is the incidence of puerperal psychosis?

A

0.2%

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14
Q

What is the incidence of baby blues?

A

70% of women

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15
Q

What is the normal time frame for the baby blues?

A

Typically seen 3-7 days postpartum with a peak of 5 days

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16
Q

Who is normally affected by baby blues?

A

Primips

17
Q

What are the features of the baby blues?

A

Anxiety

Irritable

Tearful

18
Q

What is the time frame for postnatal depression?

A

Most cases occur within a month and peak at 3 months

19
Q

What are the features of postnatal depression?

A

Similar to depression in other circumstances:

Anxiety
Low mood 
Fatigue
Irritability
Feelings of inadequacy
Ambivalence towards baby
Reduced or absent libido
20
Q

What is the time frame for puerperal psychosis?

A

Onset is usually in the first 2-3 weeks postpartum

21
Q

What are the features of puerperal psychosis?

A 
Insomnia or early morning wakening
Lability of mood
Overactivity
Disorientation
Lack of insight
Hallucinations
Persecutory beliefs
Recurrent thoughts of death
22
Q

How do we manage the baby blues?

A

Reassurance

Support

23
Q

How do we manage postnatal depression?

A

CBT

SSRIs can be used if severe

24
Q

Which SSRIs are recommended in postnatal depression?

A

Paroxetine (low milk/plasma ratio) or Sertraline

Fluoxetine not recommended because of long half life

25
Q

How do we manage puerperal psychosis?

A

Normally requires admission to hospital

Lithium not recommended with breast feeding

ECT is safe

OB/GYN (35 decks)

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