Post natal problems

Question 1

outline the most common post-natal problems

Answer 1

• post-natal anaemia
• mastitis
• post-partum thyroiditis
• postnatal depression
• sheehan’s syndrome

Question 2

post-natal anaemia severity and Mx

Answer 2

FBC day after delivery

• Hb <100g/L- oral tablets
• Hb <80g>l- iron infusion + oral tablets
• Hb <70g/L- blood transfusion + oral tablets

Question 3

aetiology of mastitis?

Answer 3

milk accumulating in the ducts

regularly expressing can prevent this

Question 4

causative organism of mastitis?

Answer 4

s.aureus

Question 5

presentation of mastitis?

Answer 5

unilateral breast tenderness, pain, erythema, swelling

+ fever

Question 6

Mx of mastitis?

Answer 6

1. conservative
   
   • analgesia + effective expressing
2. Abx (send sample of milk for mc&s)
   
   • fluclox 1st line + encourage breast feed

Question 7

complication of mastitis?

Answer 7

breast abscess

Question 8

outline the spectrum of post-natal depression

Answer 8

• baby blues
  
  • experienced by most women in week after birth, esp primips
  • tearfulness & anxiety
• post-natal depression
  
  • peak at 3 months
• puerperal psychosis
  
  • 1/1000 women
  • starts a couple weeks after birth

Question 9

how does post partum thyroiditis manifest?

Answer 9

hyper or hypothyroid

usually goes back to normal, but a small % of women remain hypothyroid

Question 10

pathophysiology of sheehan’s syndrome

Answer 10

reduced BV in PPH–> avascular necrosis of anterior pituitary gland

ant pituitary supplied by hypothalamo-hypophyseal portal system which is v suscpetible to reduced BP –> ischaemia –> necrosis

Question 11

presentation & Mx of Sheehan’s syndrome

Answer 11

presentation: hypopituitarism
mx: replacement of hormones