Post-Partum Period Flashcards
what is the the puerperium ?
the 6 weeks after delivery
Postpartum monitoring
6 week post-natal check–> offered by GP
done at the same time as the 6 week baby check!
- General wellbeing (see how mother and baby relate)
- Do BP & weight
- Do FBC if anaemic postnatally
- Scar healing after episiotomy or caesarean
- Arrange a cervical smear if due
- Contraception
- Breastfeeding
- Ask about MOOD, depression, backache, incontinence
what are some conditions that may occur Post partum?
Post partum Endometritis
Post partum Anemia
Post partum Thyroiditis
Post natal depression
what is Lochia
After what period of time would continued lochia warrant further investigation with ultrasound?
vaginal discharge containing blood mucous and uterine tissue which may continue for
6 wks after childbirth.
Endometritis
importance of maternal mental health problems in pregnancy and post partum
Depression During Pregnancy
referrels
Urgent referral to specialist mental health services if:
- should be made if the patient is severely depressed, there is a risk of self harm or suicide
- if there is a family history of severe mental illness or suicide.
Post-partum mental health problems
- types?
- screening?
- managments and referrels?
- Baby blues is seen in the first week after birth
- Postnatal depression peak in 3 months after birth
- Puerperal psychosis starting a few weeks after birth
Edinburgh Postnatal Depression Scale screen for depression:
- 10- questions w/ a max score of 30
- how mum has felt over previous week?
- includes qs about suicide
Psycosis–> Admission to the mother and baby unit, 50% chance or REOCCURANCE!
For SSRI’s:
*paroxetine is recommended bc of the low milk/plasma ratio
**fluoxetine is best avoided due to a long half-life
what is “the Mother and Baby Unit”?
is a specialist unit for pregnant women and women that have given birth in the past 12 months.
They are designed so that the mother and baby can remain together and continue to bond.
Mothers are supported to continue caring for their baby while they get specialist treatment.
post partum contraception
What scoring system is used to access the condition of the new born baby
Postpartum thyroiditis
Three stages
1. Thyrotoxicosis>> symptomatic control, such as propranolol (a non-selective beta-blocker)
2. Hypothyroidism: levothyroxine
3. Normal thyroid function (but high recurrence rate in future pregnancies)
u dont give carbimazole bc its CI in breast feeding!
Postpartum anaemia
Puerperal pyrexia
causes, managment
defined as a temp of > 38ºC in the first 14 days following delivery.
- endometritis: most common cause–> “smelly discharge”
- UTI
- wound infections (perineal tears + caesarean section)
- mastitis
- VTE
Management
if endometritis is suspected :
referred to hospital for IV antibiotics (clindamycin and gentamicin until afebrile for greater than 24 hours)
