Postnatal care Flashcards
how long after birth are women not considered fertile
21 days
give 4 methods of contraception following birth
-lactational ammenorrhea for 6 mnths
-progesterone-only pill and implant are safe and started any time after birth
-COCP avoided in breastfeeding and not started before 6 wks after birth
-copper coil or intrauterine system inserted within 48hrs after birth or >4wks
what is lactational amenorrhea
absence of periods related to breastfeeding
can be used as contraception for 6mnths after birth - women must be fully breastfeeding and amenorrhoeic
what is postpartum endometritis and when is it more common
infection of the endometrium following labour and delivery
more common in c sections, prophylactic abx are usually given
shortly after birth
foul smelling discharge or lochia
bleeding getting heavier and not improving with time
lower abdo/pelvic pain
fever
sepsis
endometritis
how is endometriosis diagnosed?
vaginal swabs (including chlamydia and gonorrhoea as these are RF)
urine culture and sensitivities
what abx are used in endometriosis both in community and in hospital
-mild case -> community oral abx -> co-amoxiclav
-septic -> inpatient -> sepsis 6 -> clindamycin and gentamicin
how does retained products of conception present and how is it diagnosed
vaginal bleeding getting heavier
abnormal vaginal discharge
low abdo or pelvic pain
fever (if infected)
USS = diagnosis
how is retained products of conception (ERPC) managed
evacuation of retained products of contraception under general anaesthetic = dilation and curettage
give 2 SE of dilation and curettage in (ERPC)
endometritis
asherman’s = adhesions form within uterus
what is defined as postpartum anaemia
Hb : <100g/l
when is a FBC done the day after delivery
PPH >500ml
c section
antenatal anaemia
symptoms of anaemia
how is postpartum anaemia with Hb of <100g/l managed
Oral ferrous sulphate 200mg 3x daily for 3 mnths
how is postpartum anaemia with Hb of <90g/l managed
consider iron infusion in addition to oral iron
How is postpartum anaemia with Hb of <70g/l managed
blood transfusion in addition to oral iron
what is a CI to an iron infusion
active infection !