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Mariam Reproductive System > Postnatal Care > Flashcards

Postnatal Care Flashcards

1
Q

How long is postnatal period (puerperium)

A

6 weeks

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2
Q

What are possible complications of breast feeding?

A
  • Mastitis - infection
  • Blocked milk ducts
  • Difficulty feeding/baby latching
  • Skin irritation – “cracked nipples”
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3
Q

What healthcare professionals usually see the mother during post natal period

A

Health visitor (usually comes 2x in 9-10 days)

6 weeks after GP checks

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3
Q

What do healthcare professionals assess for during the post natal period

A
  • Wound healing
  • Mental health
  • Infant feeding
  • Bonding
  • Social issues
    • Partner, other children, financial issues
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5
Q

Signs of mastitis

A

Red hot tender breast + systemic signs of infection

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6
Q

What are some key postnatal conditions?

A
  • Post-partum haemorrhage
  • Venous thromboembolism
  • Sepsis
  • Psychiatric disorders of the puerperium
  • Pre-eclampsia
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7
Q

What are the different categories of PPH?

A
  • Primary
    • Blood loss of >500ml within 24 hours of delivery
  • Secondary
    • Blood loss >500ml from 24 hours post partum to 6 weeks
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8
Q

What is lochia & how long does it last

A

Post natal bleeding

3-4 weeks after birth

Should be like period or less

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9
Q

Causes of secondary PPH

A
  • Retained tissue
  • Endometritis (infection)
  • Tears/trauma
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10
Q

What are the 4 Ts of PPH (

A

Tone

Trauma

Tissue (retained placenta/membrane → increased bleeding/contraction to expel the extra tissue)

Thrombin (infection)

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11
Q

Why is risk of thromboembolic diseases higher during pregnancy + post partum

A
  • Pregnancy and post partum period are hypercoagulable states
  • Immobilisation following spinal anaesthetic/caesarean section
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12
Q

Presentation of thromboembolic disease?

A
  • Unilateral leg swelling and/or pain
  • Shortness of breath
  • Chest pain
  • Tachycardia
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13
Q

What investigations are done for thromboembolic disease?

A
  • D-dimer unreliable in pregnancy
  • ECG
  • Leg dopplers
  • Chest x-ray with or without VQ scan
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14
Q

What investigation, normally used for thromboembolic disease, is not reliable during pregnancy/postnatal?

A

D-dimer

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15
Q

What is the management of thromboembolic disease?

A
  • Thromboprophylaxis and risk assessment to avoid
  • Low molecular weight heparin
  • Warfarin is teratogenic, but can be used when breast feeding
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16
Q

Causative organism of puerpegral sepsis

A

Group A Streps usually (the ones causing sore throats)

17
Q

What is puerpergal sepsis?

A

Infection of the genital tract occurring at any time between the onset of rupture of membranes or labour, and the 42nd day postpartum

18
Q

What investigations are done for puerpergal sepsis?

A
  • Perform full septic screen
    • Blood cultures, LVS, MSSU, wound swabs
19
Q

What is the management of puerpergal sepsis?

A
  • Prompt IV administration – “golden hour” (within 1 hr of presentation)
  • Antipyretic measures
  • IV fluids
20
Q

What is the incidence of mental health issues postnatally?

A
  • 25% of woman who die between 6 weeks and 1 year after pregnancy died from mental health related causes
    • 1/7 of those is suicide
21
Q

What team is used to manage postnatal mental health issues?

A

Peri-natal mental health team is used to manage this

22
Q

What are some postnatal mental health issues?

A
  • Baby blues
  • Postnatal depression
  • Puerperal psychosis
23
Q

What is the aetiology of baby blues?

A
  • Affects most woman due to hormonal changes around the time of birth
24
Q

What is the management of baby blues?

A
  • No specific treatment as does not affect functioning
25
Q

When can postnatal depression continue from?

A

Can continue from baby blue or start sometime later

26
Q

What are risk factors for postnatal depression?

A
  • Personal or family history of affective disorder
27
Q

What is the presentation of postnatal depression?

A
  • Classical depressive symptoms
  • Affects functioning and bonding, requiring treatment
28
Q

What is puerperal psychosis?

A

Mental disorder occurring after childbirth, characterised by deep depression, delusions of childs death and homicidal feelings towards child

29
Q

What are risk factors for puerperal psychosis?

A
  • Personal or family history of affective disorder, bipolar disorder or psychosis
30
Q

Is the incidence of puerperal psychosis common or rare?

A

Rare

31
Q

What is the management of puerperal psychosis?

A
  • Inpatient psychiatric care
  • Woman is a danger to themselves and their baby
32
Q

What is pre-eclampsia?

A

Pre-eclampsia = causes hypertension during pregnancy and after labour

33
Q

What is the management of pre-eclampsia?

A
  • Discharge on antihypertensive
  • Follow up in community

Mariam Reproductive System (35 decks)

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