Postnatal Complication

Question 1

Define a secondary PPH

Answer 1

Occurring after 24 hours post delivery and before the end of the puerperium (period of about 6 weeks after childbirth where maternal reproductive organs return to pre pregnant condition) and any amount of blood loss that adversely effects the mother

Question 2

Why might we not recognise a PPH

Answer 2

Failure to estimate blood loss correctly
Failure for woman to recognise abnormal blood loss or tell a midwife about excessive blood loss (incidious bleeding)
Failure to recognise occult bleeding and build up in intravascular space

Question 3

What are the risk factors for a PPH

Answer 3

Retained products
Endometritis 
Infection
Lacerations
Chronic uterine inversion

Question 4

Define endometritis

Answer 4

And infection resulting from contamination of the endometrial cavity with vaginal organisms during labour and delivery

Question 5

Signs and symptoms for endometritis (6)

Answer 5

Pyrexia
Flu like symptoms
Tender uterus
Offensive lochia
Tachycardia
Abnormal vaginal bleeding

Question 6

Define a haematoma

Answer 6

Caused by damage to blood vessels during delivery of following repair of episiotomy or tear causing bleeding to distend into surrounding tissue which may not be visible straight away depending on its site and can lead to secondary PPH

Question 7

Signs and symptoms of haematoma

Answer 7

Severe pain in rectum/vulval area
Vulval swelling
Woman being symptomatic of blood loss without visible blood loss

Question 8

Floss is 2 days PN and has rung you saying she’s soaked through her last 2 pads within an hour. She also says she’s passed quite big clots and is feeling very lightheaded what’s your management plan?

Answer 8

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Question 9

Jess rings you on triage saying she’s been feeling very unwell the past 2 days since her LSCS and has been feeling like she has the flu what is your management plan?

Answer 9

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