Post-Partum Complications

Question 1

examples of post-partum problems

Answer 1

VTE
infection (puerperal sepsis)
incontinence
lactation problems

Question 2

management of VTE

Answer 2

 Low risk= hydration and mobilisation
 Moderate risk= 10 days LMWH
 High risk= 6 weeks LMWH

Question 3

risk factors for puerperal sepsis

Answer 3

prolonged labour
multiple vaginal examinations
retained placental tissue
C/S

Question 4

causative organisms of puerperal sepsis

Answer 4

group B strep
staph
E. coli
anaerobes

Question 5

risk of spread of sepsis

Answer 5

endometritis > salpingitis > pelvic infection > abscess > peritonitis

Question 6

diagnosis of infection

Answer 6

bloods
USS
CT

Question 7

management of infection

Answer 7

IV co-amoxiclav, metronidazole +/- gentamicin

IV fluids

Question 8

cause of urinary incontinence in developing world?

Answer 8

vesico-vaginal fistula

Question 9

what causes formation of a fistula in labour?

Answer 9

prolonged obstructed labour
tissue compressed by baby’s head
baby usually dies
tissue necrosis

Question 10

examples of problems with lactation

Answer 10

cracked/ sore nipples
breast engorgement
mastitis
breast abscess

Question 11

common cause of mastitis

Answer 11

staph aureus