Postpartum

Question 1

What does “puerperal” mean?

Answer 1

of, relating to, or occurring during childbirth or the period immediately following.

Question 2

What factors increase the risk of puerperal infection?

Answer 2

prolonged labor, prolonged ROM, multiple vaginal exams, internal fetal monitoring, manual removal of the placenta

Question 3

What is the most common cause of postpartum fever?

Answer 3

endometritis (more common in c-sections)
Usually polymicrobial (staph and strep, aerobic and anaerobic)

Question 4

Signs and symptoms of depression that last ____ are considered post-partum blues

Answer 4

less than 2 weeks

Question 5

Breast feeding is associated with decreased risk of ___ cancer

Answer 5

ovarian

Question 6

What type of birth control method may affect lactation and the ability to breast feed?

Answer 6

estrogen containing

Question 7

What is the most common bacteria causing mastitis?

Answer 7

Staph

Question 8

What hormones DECREASE with delievery?

Answer 8

progesterone and estrogen

Question 9

___ withdrawal after delivery aids in allowing prolactin to stimulate alpha-lactalbumin production to increase lactose synthase.

Answer 9

progesterone

Question 10

Bilateral nipple pain after breast feeding may be associated with…

Answer 10

candidiasis infection

Question 11

Prolactin is responsible for milk ___ while oxytocin is responsible for milk ___.

Answer 11

production

ejection

Question 12

What is the most common cause of postpartum hemorrhage?

Answer 12

Uterine atony

Question 13

What are risk factors for uterine atony?

Answer 13

precipitous labor, multiparity, general anesthesia, oxytocin use, prolonged labor, macrosomia, hydramnios, twins, chorio

Question 14

What is the mechanism of methylergonovine?

Answer 14

(AKA - methergine) ergot alkaloid - potent smooth muscle constrictor

Question 15

Which women should NOT receive methergine?

Answer 15

HTN and preeclampsia

Question 16

What is the MOA of prostaglandin F2-alpha?

Answer 16

smooth muscle constrictor

hemabate

Question 17

Which women should NOT receive prostaglandin F2-alpha?

Answer 17

h/o asthma

Question 18

What is the definition of postpartum hemorrhage?

Answer 18

500cc after vaginal

1000 cc after cesarean

Question 19

What is a B-lynch suture used for?

Answer 19

uterine compression to control unresponsive uterine atony

Question 20

What is a common complication of prolonged labor and prolonged ROM?

Answer 20

endometritis

Question 21

What is the best treatment for endometritis following vaginal birth?

Answer 21

gentamicin and ampicillin

Question 22

What are the symptoms of endometritis?

Answer 22

fever, maternal tachycardia, uterine tenderness, non localizing signs of infection

Question 23

What is the best treatment for endometritis following cesarean delivery?

Answer 23

gentamicin and clindamycin

Question 24

What are complications of epidurals?

Answer 24

spinal headache, localized back pain, meningitis

Question 25

Postpartum blues lasts ___ weeks.

Answer 25

two

Question 26

(T/F) SSRIs are safe to use while breast feeding.

Answer 26

TRUE

Question 27

What are SE of SSRI use during the third trimester?

Answer 27

abnormal muscle movements and withdrawal symptoms

Question 28

What is postpartum hair loss called?

Answer 28

postpartum telogen effluvium

Question 29

What causes postpartum hair loss?

Answer 29

high estrogen levels during pregnancy increases synchrony of hair growth - so then it all sheds at the same time 1-5 months postpartum