Postnatal Flashcards
Normal postnatal care
Analgesia
Establishing breast or bottle feeding
VTE risk assessment
Monitoring for postpartum haemorrhe, sepsis, blood pressure, recovery after c section and perineal tear
FBC
Anti-D
Baby check
When is contraception required after birth
21 days after birth
Options for post partum contraception
Lactational amenorrhea - 98% effective for 6 months if fully breast feeding and amenorrhoeic
POP - safe in breast feeding
COCP - avoid if breast feeding, started after 6 weeks
Coil - inserted within 48 hours of birth or after 4 weeks
Define postpartum endometritis
Inflammation of the endometrium caused by infection in the postpartum period acquire during or after labour
Presentation of endometritis
Shortly after birth
Foul smelling discharge pr lochia
Bleeding that gets heavier or does not improve with time
Lower abdominal or pelvic pain
Fever
Sepsis
Investigations in endometritis
Vaginal swabs
Uterine culture and sensitiviteis
US
Sepsis six
Define retained products of conception
When pregnancy-related tissue remains in the uterus after deliver - also after miscarriage or TOP
Placental tissue or fetal membranes
Presentation of retained products of conception
Vaginal bleeding - heavier or not improving
Abnormal vaginal discharge
Lower abdominal pelvic pain
Fever
Investigations in retained products of conception
Ultrasound!
Management of retained products of conception
Evacuation of retained products - dilatation and curettage
Common cause of adhesions
Define postpartum anaemia
Define as haemaglobin of <100 in postpartum period
Commonly due to acute blood loss
Management of postpartum anaemia
FBC
<100 oral iron
<90 iron transfusion + oral iron
<70 blood transfusion + oral iron
Dont give iron in acute infection
Define baby blues
Low mood in the postnantal period often seen in first week or so after birth
Define postnatal depression
Low mood in the postnatal period with a peak round 3 months after birth
Define puerperal psychosis
Psychosis starting few weeks after birth
PResentation of baby blues
Mood swings
Low mood
Anxiety
Irritability
Tearfulness
Often relates to being a poor parent
Management of baby blues
Often transient - resolves within 2 weeks of delivery
Presentation of postnatal depression
Low mood
Anhedonia
Low energy
Around 3 months post delivery - symptoms present for at least 2 weeks
Management of postnatal
Mild - supportive management, encourage self help
Moderate - SSRI + CBT
Sever - Specialist or mother baby unit
Presentation of puerperal psychosis
Delusion
Hallucination
Depression
Confusion
Mania
Thought disorder
Management of puerperal psychosis
Admission to the mother baby unit
CBT
Medicaiton
ECT
Define mastitis
R+Inflammation of the breast tissue - common complication of breast feeding
Caused by obstruction or infection
Presentation of mastitis
Breast pain and tenderness - unilateral
Erythema in focal area of breast
Local warmth and inflammation
Nipple discharge
Fever
Management of mastitis
Blockage - conservative, continue breastfeeding and expressing, heat packs, simple analgesia
Infection - flucloxacillin, sample for culture, encourage breastfeeding and expressing
Abscess require incision and drainage
