Post natal complications

Question 1

What is the post-natal period?

Answer 1

The puerperium.

Its the first 6 weeks after the baby is born

Question 2

What checks are done post-natally?

Answer 2

• midwife up to 9-10 days
• health visitor after midwife
• GP check at 6 weeks

Question 3

When can women become pregnant after labour?

Answer 3

21 days after giving birth

Question 4

What are common complications of breast feeding?

Answer 4

• mastitis
• blocked milk ducts
• difficulty feeding
• skin irritation

Question 5

How is mastitis treated?

Answer 5

• antibiotics - flucloxacillin (no risk to neonate)
• massage breasts
• feed more often on affected side
• express milk

^Trying to reduce milk build up and blockage

Question 6

What is a primary postpartum haemorrhage?

Answer 6

blood loss >500mls within 24 hrs

Question 7

What is a secondary postpartum haemorrhage?

Answer 7

Blood loss >500mls from 24hrs - 6 weeks post partum

Question 8

What are causes of post partum haemorrhage?

Answer 8

TONE (uterine atony)
TRAUMA (injuries during childbirth, perineal tear)
TISSUE (retained placenta or membranes)
THROMBIN (abnormal clotting)

Question 9

what is lochia?

Answer 9

bleeding from the vagina
should be the equivalent of a period
can be heavier when breast feeding because it causes the womb to contract

Question 10

When will you period begin after birth?

Answer 10

as early as 5-6 weeks if bottle feeding

usually later if breast feeding, might not start until you begin to reduce breast feeding

Question 11

When should lochia stop?

Answer 11

2-6 weeks after labour.

Question 12

What are the thromboembolic diseases associated with pregnancy?

Answer 12

Pulmonary embolism

Deep venous thrombosis

Question 13

How long is a female in a hyper coagulable state?

Answer 13

During pregnancy and for 6 weeks post natally.

Question 14

When is thrombotic prophylaxis given?

Answer 14

• after cesarean section

Question 15

how high is the risk of a DVT or PE during or after pregnancy?

Answer 15

6-10 times higher

Question 16

What are the signs and symptoms of thromboembolic disease?

Answer 16

DVT:
- unilateral leg swelling or pain

PE:

• SOB
• chest pain
• UNEXPLAINED TACHYCARDIA

Question 17

What treatment should be given for thromboembolic disease?

Answer 17

• low molecular weight heparin

- warfarin (teratogenic but can be used when breast feeding)

Question 18

When should women with suspected sepsis be treated?

Answer 18

Within 1 hr with IV antibiotics

Question 19

What is the most common organism causing puerperal sepsis?

Answer 19

Group A streptococcus.

Question 20

What are baby blues?

Answer 20

A normal part of the post natal period
within a couple of days (1-3)
women will be excessively tearful and feeling low

Question 21

what treatment is given for baby blues?

Answer 21

No specific treatment

reassurance that this is normal

Question 22

What is post-natal depression?

Answer 22

• can continue from baby blues or start separately

- classic depressive symptoms

Question 23

Who is at increased risk of post-natal depression?

Answer 23

• previous post natal depression

- family history of affective disorder

Question 24

What is puerperal psychosis?

Answer 24

a rare but serious psychotic illness in the post natal period

Question 25

how is puerperal psychosis treated?

Answer 25

inpatient psychiatric care (in mother and baby unit)

Question 26

Who is at risk of puerperal psychosis?

Answer 26

• personal or family history of affective disorder, bipolar disorder or psychosis

Question 27

How does pre-eclampsia affect post natal women?

Answer 27

Most eclamptic seizures occur in the postnatal period

- it can develop post-nasally or might worsen

Question 28

How does eclampsia affect post natal women?

Answer 28

Most eclamptic seizures occur in the postnatal period

- it can develop post-nasally or might worsen

Question 29

What is the treatment for eclampsia?

Answer 29

Antihypertensives.