postnatal care

Question 1

postnatal period

Answer 1

first 6wks after baby born

Question 2

how long see midwife athome

Answer 2

first 9/10 days, thereafter referred healthvisitor

Question 3

what does health visitor/midwife check for whilst visiting at home

Answer 3

signs of abnormal bleeding, infection

debrief events around birth

mental health

Question 4

when do they go for postnatal check at GP

Answer 4

6wks

Question 5

what is discussed at 6wk check at GP

Answer 5

contraception
mental health
general wellbeing

Question 6

common problems during postnatal period

Answer 6

probs w infant feeding
probs w bonding

social issues - partner, other children, financial issues

Question 7

complications of breast feeding

Answer 7

mastitis - infection
blocked milk ducts
difficulty feeding/baby latching
skin irritation ‘cracked nipples’

Question 8

primary post partum heamorrhage

Answer 8

> 500ml within 24hr delivery

Question 9

primary post partum heamorrhage: 4Ts

Answer 9

tone of uterus
trauma
tissue
thrombin

Question 10

primary post partum heamorrhage: tone of uterus

Answer 10

womb doesn’t contract well enough after delivery and so significant bleeding

Question 11

primary post partum heamorrhage: trauma

Answer 11

perineal tears and injuries following childbirth may be vascular and bleed

Question 12

primary post partum heamorrhage: tissue

Answer 12

retained tissues e.g. placenta, membranes

uterus will try to contract to dispel them

Question 13

primary post partum heamorrhage: thrombin

Answer 13

coagulopathy, bleeding and haemorrhage following abnormal clotting process after birth

Question 14

secondary post partum haemorrhage

Answer 14

blood loss >500ml from 24hrs postpartum to 6wks after

Question 15

secondary post partum haemorrhage: causes

Answer 15

retained tissue
endometritis - infection of endometrial lining
tears/trauma

Question 16

how to reduce risk of postnatal thromboembolic disease

Answer 16

high risk quality assessment and appropriate thromboprophylaxis e.g. after CS

Question 17

what does sepsis in post natal period often include

Answer 17

group A streptococcus

Question 18

baby blues

Answer 18

affects most women due to hormonal changes around time of birth - usually 1-3 days after

does not affect functioning and requires no specific treatment

excessive tearfullness and low mood

Question 19

postnatal depression

Answer 19

affects functioning, bonding with baby and often needs Rx

increased risk in women with personal or family Hx affective disorder

Question 20

puerperal psychosis

Answer 20

rare but serious

woman can be danger to herself and bbay, requires inpatient psych care ideally in a mother and baby unit

Question 21

when do most eclamptic fits occur

Answer 21

postnatal period

Question 22

commonest cause maternal death

Answer 22

thromboembolic disease

Question 23

most usual cause sepsis post natal period

Answer 23

group a strep