Postnatal Care Flashcards
What is the postnatal period?
First 6 weeks after the baby is born
Midwife visits at home for first 9-10 days
What is discussed and checked by midwife in first 9-10 days?
Observe for signs of abnormal bleeding
Observe for signs of infection
Debrief events around birth
Mental health
What is discussed at 6 week postnatal check at GP?
Contraception
Mental health/ general wellbeing
What are common problems experienced in the postnatal period?
Problems with infant feeding, bonding and social issues
What are some complications of breast feeding?
Mastitis
Blocked milk ducts
Difficulty feeding/ baby latching
Skin irritation
What are some key postnatal conditions?
Post partum haemorrhage, venous thromboembolism, sepsis and psychiatric disorders of puerperium
What is a primary PPH - postpartum haemorrhage?
Blood loss of more than 500ml within 24hrs of delivery
What are the causes of primary PPH?
Tone, trauma, tissue and thrombin
What is a secondary PPH?
Blood loss more than 500ml from 24hrs post partum to 6 weeks
Retained tissue, endometritis and tears
What is lochia?
Is normal bleeding for 3-4 weeks postnatal - should be like a period or less
Describe thromboembolic disease and postnatal period
Pregnancy is a hypercoagulable state
Pregnant women are 6-10 more likely to develop thromboembolism
What are signs thromboembolic disease?
Unilateral leg swelling and/ or pain
SOB or chest pain
Unexplained tachycardia
What investigations are done for thromboembolic disease in pregnancy?
ECG, leg dopplers, CXR, VQ scan and treat with low molecular weight heparin
D-dimer is unreliable
What is given for puerperal sepsis?
Prompt IV antibiotic administration if suspect - golden hour
Perform full septic screen - blood culture, LVS, MSSU and wound swabs
IV fluids
What is baby blues?
Affects most women due to hormonal changes around the time of both - usually 1-3 days PN
Does not affect functioning and requires no specific treatment
Describe postnatal depression
Can continue on from baby blues
Has classic depression symptoms
Affects functioning, bonding and often requires treatment
Increased risk if personal or FH
Describe puerperal psychosis
Rare but serious
Women can be danger to themselves and their babies
Requires inpatient psychiatric care
Increased risk if personal or FH of affected disorder
When do most eclamptic seizures occur?
In postnatal period - women discharged on antihypertensives and follow up in community
