Post Partum Care

Question 1

If someone is Rh Negative what do you do after delivery

Answer 1

Give Rhogam 200 IM within 72 hours

Question 2

Contraception options for breast feeding or non breastfeeding

Answer 2

IUD at 6 weeks for all

Micronor 6 weeks postparum if breast feeding and can switch to OCP when supplemental feeding introduced

OCP at 3 months if breast feeding exclusively

OCP at 3 weeks postpartum if not breastfeeding

Question 3

Risks for postpartum hemorrhave

Answer 3

Prior history
Rapid or prolonged delivery
Shoulder dystocia
Instrumentation

Question 4

Etiology for PPH

Answer 4

Tone
Tissue
Trauma
Thrombin

Question 5

Management of PPH

Answer 5

ABC
Type and screen 4 units
2 large bore IVs
Uterine massage

Oxytocin on infusion
Ergotamine
Hemabate

Surgery (ligation of artery, hysterectomy, D+C)

Question 6

Post partum fever

Answer 6

Pneumonia
UTI
Wound
DVT
Endometriitis
Mastitis

Question 7

How to manage thyroid after birth

Answer 7

Will likely need to decrease thyroxine dose
Can develop new hypothryoidism at 6-12 months

Question 8

Postpartum depression risks and treatment
Use the Edinburgh postpartum depression scale

Answer 8

Person or family history
Poor support
Sick infant

CBT
Citalopram, escitalopram, Sertraline

2nd line=Buproprion, duloxetine, mirtazapine, Venlafaxine

Question 9

When can you do a TOL after section

Answer 9

18 months out with no contraindications to vaginal delivery

Question 10

What are the main bacterial causes of mastitis?

Answer 10

A. Aureus, B hemolytic strep, E.coli