Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Theo's Obs And Gynae > Post Partum Care > Flashcards

Post Partum Care Flashcards

0
Q

What is colostrum?

A

Yellow fluid secreted by breasts for 4-5 days post partum

Contains more minerals and protein than mature milk, but less sugar and fat

Contains high concentration of IgA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

What are normal changes in the puerperium?

A

Bhcg levels fall
Uterus decreases in size
Vagina swollen initially, may be fragile
Cervix- gradually closes over 2 weeks
Perineum- oedema
Lochia- discharge, initially red then yellowish
Breast- become endorsed between 2nd and 4th days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is in mature breast milk?

A

High concentration of lactose
Vitamins (except k)
Immunoglobulin
Antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How much milk is produced?

A

Increases to 500ml at five days post partum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How should breast feeding be initiated and continued?

A

Initiation:
Skin to skin contact post delivery
Feed within first two hours of birth

Ensure babies head and body are inline
Support babies head and shoulders
Baby needs a mouthful of breast from underneath the nipple
Chin should touch breast

Continuation:
Feeds infrequent during first 24-48 hours, then increase gradually and peak at 5th day - around 3-6 hourly

Demand feeding should be encouraged- prevents engorgement

Cows milk is not suitable until a baby is 1 year - too much salt, not enough food

Can switch to solid food at 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the advantages of breast feeding?

A 
For infant:
Reduced gastrointestinal infection
Reduced UTIs
Reduced respiratory infections
Less atopic illness
Reduced leukaemias
For mother:
Prevents against breast, ovarian cancer, osteoporosis
Amenorrhoea and contraception
It's free - bottles cost 450
Promotes bonding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the disadvantages of breast feeding?

A

Inadequate milk supply - affects less than 1%, can be treated

Breast engorgement - treat by express milk, warm showers and cold compresses

mastitis, breast abscess - continue breastfeeding

Sore or cracked nipples - may be corrected by position - breastfeeding nurse

Transmission of drugs and infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What drugs are generally contraindicated in breastfeeding?

A 
Amiodarone
Antineoplastic
Chloramphenicol
Ergotamine
Cabergoline
Ergot alkaloids
Iodides
Methotrexate
Lithium
Tetracycline
Pseudoephedrine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is puerperal pyrexia defined?

A

Defined as temperature >38 degrees in any occasion in first 14 days after delivery

Slight fever is not uncommon in 1st 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the genital causes of puerperal pyrexia?

A

Endometritis - associated with foul profuse and bloody discharge, with tender bulky uterus

Perineal wound infection- including episiotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the nongenital causes of puerperal pyrexia?

A

Mastitis, breast abscess
UTIS
Thrombophlebitis
Respiratory complications - usually after Caesarean section
Abdominal wound infection - usually post caesarean

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How is puerperal pyrexia defined?

A

Defined as temperature >38 degrees in any occasion in first 14 days after delivery

Slight fever is not uncommon in 1st 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the genital causes of puerperal pyrexia?

A

Endometritis - associated with foul profuse and bloody discharge, with tender bulky uterus

Perineal wound infection- including episiotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the nongenital causes of puerperal pyrexia?

A

Mastitis, breast abscess - fluclox
UTIS
Thrombophlebitis
Respiratory complications - usually after Caesarean section
Abdominal wound infection - usually post caesarean

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How should puerperal pyrexia be investigated?

A 
FBC
Blood cultures
MSU
Swabs from cervix and lochia for chlamydia and bacterial culture
Wound swabs
Throat swabs
Sputum culture and chest radiographs

Aim to identify most likely source of infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How should puerperal pyrexia be managed?

A

Supportive:
Analgesics and NSAIDS
Wound care in case of wound infection
Ice packs

Antibiotics:
Depends on source if infection

Surgical:
Incision and drainage of breast abscess
Secondary repair of wound

16
Q

What other complications may occur in the postnatal period?

A

Pain - after pains from uterine contraction for 4 days

Urinary retention - following instrumental delivery

UTI

Constipation - osmotic stool softeners

Symphysis pubis discomfort - usually resolves in 6-8 weeks- can wear supportive belt

Maternal obstetric paralysis - foot drop due to lumbosacral nerve damage

17
Q

How common is post partum psychosis?

A

Affects 1/2 in a 1000

18
Q

What are risk factors for postpartum psychosis?

A

Past history of postpartum psychosis

Past history of bipolar disorder

Family history of postpartum psychosis or bipolar disorder

19
Q

When postpartum psychosis present?

A

10-14 days postpartum

20
Q

How should postpartum psychosis be managed?

A

Antipsychotic and or mood stabilising drug

Take into account breastfeeding

Education and supportive therapy

Admit to mother and baby unit

21
Q

How often does postpartum psychosis recur?

A

20% will have further psychosis if they become pregnant again

50% will have another psychotic episode at another point in their life

22
Q

How common are the baby blues?

A

Occur in greater than 50% of women

23
Q

When do postnatal blues begin, peak and end?

A

Begins days 2-4
Peaks days 4-6
Lasts for 2-7 days

24
Q

What are the symptoms of the baby blues?

A 
Emotional lability
Tearfulness
Sadness
Sleep disturbance
Poor concentration
Restlessness
Headaches

Mother may feel vulnerable and rejected and may show undue concern for baby

25
Q

How is baby blues managed?

A

Reassurance and support

Antenatal preparation may help

26
Q

What is the onset of postnatal depression

A

10-25% of women in first postnatal year

27
Q

What are the risk factors for postnatal depression?

A 
Previous mental health problems
Poor social support
Poor relationship with partner
Baby blues
Recent major life events
Unplanned pregnancy
Not breastfeeding
Unemployment
Longer time to conception
Substance abuse
28
Q

How quickly do symptoms of postnatal depression appear and how long do they last?

A

Develop 2-3 months postpartum

Resolves slowly after 6-12 months

29
Q

How does postnatal depression present?

A

Features of depression

Particularly:
Irritability
Tiredness
Reduce libido
Guilty feelings about parenting abilities
Anxieties over babies health
Feeling of inability to cope with baby
30
Q

How is postpartum depression managed?

A

In 2/3rds, self limiting
In 1/3rd, severe or sustained disease

Management:
Reassurance

Mild

  • self help/supportive care
  • consider antidepressant if previous episode of depression

Moderate /severe

  • CBT
  • consider antidepressants
  • consider admission to mother and baby unit
31
Q

What is the prognosis of post natal depression?

A

Most cases resolve within 3-6 months

A quarter of women will still have symptoms a year later

32
Q

Where should suspected endometritis be managed!

A

Admit to hospital for IV antibiotics

Clindamycin and gentamicin until a febrile for greater than 24 hours

Theo's Obs And Gynae (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions