Postpartum

Question 1

Define perinatal depression

Answer 1

Depression experienced at any time in the antenatal period or in the 12 months postnatally

Question 2

Symptoms of depression

Answer 2

5 out of 9, present for 2 or more weeks ( A SAD FACES)
- appetite change
- sleep changes
- anhedonia
- depressed mood most of the day almost every day
- fatigue/ lethargy
- agitation (psychomotor)
- concentration diminished
- low self- Esteem
- suicidal ideation/ thoughts of death

Question 3

WHO 10 steps to successful breastfeeding

Answer 3

Hospital policies
Staff competency
Antenatal care- discuss importance of breastfeeding
Care after birth- encourage skin to skin contact immediately after birth
Support mothers with breastfeeding- check positioning, attachment and suckling; give practical breastfeeding advice; help with common problems
Supplementing- give only breastmilk unless other medical indications
Rooming in- make sure mothers of sick babies can stay nearby
Responsive feeding
Counsel mothers on the use and safety of bottles, tests and pacifiers
Discharge- make sure women have breastfeeding support in the community

Question 4

Pertussis vaccination timing in antenatal period

Answer 4

28- 32 weeks

Question 5

Effects of influenza VACCINE to mum and fetus

Answer 5

Mum: prevents 1-2 hospitalisation per 1000 women; reduces lab- confirmed influenza by 50%

Baby: reduced fish of stillbirth, neonatal influenza, hospitalisation and death

Question 6

Define puerperal sepsis

Answer 6

Life- threatening organ dysfunction developing within 6 weeks of birth

Question 7

Maternal sepsis

Answer 7

A life- threatening condition defined as organ dysfunction resulting from infection during pregnancy, childbirth, post- abortion or postpartum period

Question 8

Puerperal fever

Answer 8

Temp rise to >/ = 38C maintained over 24 hours in the first 10 days after delivery

Question 9

Septic shock

Answer 9

Underlying circulatory and metabolic abnormalities associated with increased mortality indicated by:
- hypotension requiring vasopressor therapy to maintain a MAP of 65 or greater
- serum lactate greater than 2mmol/L
Despite adequate fluid resuscitation

RCOG: the persistence of hypoperfusion despite adequate fluid replacement therapy

Question 10

Define sepsis

Answer 10

Life threatening organ dysfunction caused by a dysregulated host response to infection

RCOG definition: infection + systemic manifestation of infection