Post natal complications Flashcards
What is the post-natal period?
The puerperium.
Its the first 6 weeks after the baby is born
What checks are done post-natally?
- midwife up to 9-10 days
- health visitor after midwife
- GP check at 6 weeks
When can women become pregnant after labour?
21 days after giving birth
What are common complications of breast feeding?
- mastitis
- blocked milk ducts
- difficulty feeding
- skin irritation
How is mastitis treated?
- antibiotics - flucloxacillin (no risk to neonate)
- massage breasts
- feed more often on affected side
- express milk
^Trying to reduce milk build up and blockage
What is a primary postpartum haemorrhage?
blood loss >500mls within 24 hrs
What is a secondary postpartum haemorrhage?
Blood loss >500mls from 24hrs - 6 weeks post partum
What are causes of post partum haemorrhage?
TONE (uterine atony)
TRAUMA (injuries during childbirth, perineal tear)
TISSUE (retained placenta or membranes)
THROMBIN (abnormal clotting)
what is lochia?
bleeding from the vagina
should be the equivalent of a period
can be heavier when breast feeding because it causes the womb to contract
When will you period begin after birth?
as early as 5-6 weeks if bottle feeding
usually later if breast feeding, might not start until you begin to reduce breast feeding
When should lochia stop?
2-6 weeks after labour.
What are the thromboembolic diseases associated with pregnancy?
Pulmonary embolism
Deep venous thrombosis
How long is a female in a hyper coagulable state?
During pregnancy and for 6 weeks post natally.
When is thrombotic prophylaxis given?
- after cesarean section
how high is the risk of a DVT or PE during or after pregnancy?
6-10 times higher
What are the signs and symptoms of thromboembolic disease?
DVT:
- unilateral leg swelling or pain
PE:
- SOB
- chest pain
- UNEXPLAINED TACHYCARDIA
What treatment should be given for thromboembolic disease?
- low molecular weight heparin
- warfarin (teratogenic but can be used when breast feeding)
When should women with suspected sepsis be treated?
Within 1 hr with IV antibiotics
What is the most common organism causing puerperal sepsis?
Group A streptococcus.
What are baby blues?
A normal part of the post natal period
within a couple of days (1-3)
women will be excessively tearful and feeling low
what treatment is given for baby blues?
No specific treatment
reassurance that this is normal
What is post-natal depression?
- can continue from baby blues or start separately
- classic depressive symptoms
Who is at increased risk of post-natal depression?
- previous post natal depression
- family history of affective disorder
What is puerperal psychosis?
a rare but serious psychotic illness in the post natal period
how is puerperal psychosis treated?
inpatient psychiatric care (in mother and baby unit)
Who is at risk of puerperal psychosis?
- personal or family history of affective disorder, bipolar disorder or psychosis
How does pre-eclampsia affect post natal women?
Most eclamptic seizures occur in the postnatal period
- it can develop post-nasally or might worsen
How does eclampsia affect post natal women?
Most eclamptic seizures occur in the postnatal period
- it can develop post-nasally or might worsen
What is the treatment for eclampsia?
Antihypertensives.
