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Y3 repro > postnatal care > Flashcards

postnatal care Flashcards

1
Q

what is the postnatal period

A

aka puerperium

first 6wks after baby is born

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2
Q

who initially monitors the mum and baby

A

midwife at home for first 9-10 days

referred to health visitor thereafter

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3
Q

what are the midwife and health visitor monitoring for

A

observe for signs of abnormal bleeding
evidence of infection - wound (perineal/CS), endometritis, breast
debrief events around birth (esp if CS)
mental health

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4
Q

when is the postnatal check at the GP

what is covered

A

6wks
contraception
mental health/general wellbeing

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5
Q

common problems in the postnatal period

A

infant feeding
bonding
social issues - partner, other children, financial issues

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6
Q

common problems in the postnatal period

A

infant feeding
bonding
social issues - partner, other children, financial issues

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7
Q

breast feeding - what to cover

A

women should be advised re. benefits of breast feeding but supported whatever their feeding choice
prescribing in breast feeding

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8
Q

complications from breast feeding

A

mastitis
blocked milk ducts
difficulty feeding/baby latching
skin irritation (cracked nipples)

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9
Q

key postnatal conditions

A 
PPH
venous thromboembolism 
sepsis
psychiatric disorder of the puerperium 
pre-eclampsia
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10
Q

what is lochia

A

the vaginal discharge you have after a vaginal delivery. It has a stale, musty odor like menstrual discharge.
Lochia for the first 3 days after delivery is dark red in color. A few small blood clots, no larger than a plum, are normal

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11
Q

how long is lochia normal for

A

3-4wks postnatal

should be like a period or less

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12
Q

thromoboemoblic disease - why does it occur

A

pregnancy and the immediate post partum period is a hypercoagulable state
pregnant women 6-10x more likely to develop DVT/PE

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13
Q

what helps reduce risk of thromboembolism

A

high quality risk assessment

appropriate thromboprophylaxis

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14
Q

when to be suspicious of thromboembolic disease

A

women w/ unilateral leg swelling/pain and women complaining of SOB/chest pain

sometimes the only sign of PE will be unexplained tachycardia

may present atypically in pregnancy/postnatally

ALWAYS HAVE HIGH INDEX OF SUSPICION FOR VTE IN PREGNANT/POSTNATAL WOMEN

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15
Q

when to be suspicious of thromboembolic disease

A

women w/ unilateral leg swelling/pain and women complaining of SOB/chest pain

sometimes the only sign of PE will be unexplained tachycardia

may present atypically in pregnancy/postnatally

ALWAYS HAVE HIGH INDEX OF SUSPICION FOR VTE IN PREGNANT/POSTNATAL WOMEN

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16
Q

what further increases risk of thromboembolism

A

immobilisation following spinal anaesthetic/CS

17
Q

what value is unreliable in pregnancy regarding thromboembolism

A

D dimer

18
Q

investigations for thromboembolism

A

ECG
leg dopplers
CXR +/- VQ scan or CTPA - NB radiation exposure during pregnancy/BF
treat w/ low molecular weight heparin

warfarin is teratogenic but can be used when BF

19
Q

puerperal sepsis presentation

A

may present atypically

20
Q

management of puerperal sepsis

A

in any woman w/ suspected sepsis - prompt IV abx (golden hour)

full septic screen - bloods, LVS, MSSU, wound swabs

antipyretic measures, IV fluids, referral to hospital if concerned re. sepsis

21
Q

mortality with postnatal mental health

A

1/4 of women who died 6wks-1yr after pregnancy died from mental health related causes, 1/7 of these from suicide

suicide is the 2nd largest cause of direct maternal deaths during/wiithin the 42 days after birth

22
Q

what are the baby blues

A

affects most women due to hormonal changes around time of birth - 1-3 days PN
doesn’t affect functioning
requires no specific treatment

23
Q

postnatal depression

A

can continue from baby blues or start later
classical depressive symptoms
affects functioning, bonding and often requires treatment

24
Q

who is at higher risk of postnatal depression

A

personal/FHx of affective disorder

25
Q

puerperal psychosis

A

rare but serious
women can be a danger to themselves and their babies
requires inpatient psychiatric care

26
Q

who is at higher risk of puerperal psychosis

A

personal/FHx of affective disorder, bipolar disorder or psychosis

27
Q

post-natal hypertensive disorders

  • when do eclamptic seizures occur
  • development of pre-eclampsia
  • treatment
A

most eclamptic seizures occur in the postnatal period
pre-eclampsia can develop postnatally or may worsen several days following delivery
women may be discharged on anti-hypertensives - follow up in community

Y3 repro (47 decks)

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