postpartum Flashcards
what is the puerperium and how long does it last
period of repair and recovery where tissues return to non pregnant state lasting 6 weeks on average
how long are changes in discharge expected to last
1st 3 weeks
describe rubra
3-4 days after birth , fresh red
describe serosa
4-14 days, brown red and watery
describe alba
10-20 days and yellow
after how many days post partum does the endometrial lining regenerate
7 days
where does the fundus usually sit during pregnancy and after pregnancy how long does it take to return to norm position
pregnancy sits at umbilicus and around 2 weeks
after birth how long will diuresis go on for
a few days
what is colostrum and when is it produced
around week 16 of pregnancy - a thick yellowish protein rich substance essential for early immunological protection
what initiates lactation
explusion of placenta
what hormones block lactation by blocking prolactin release
oestrogen and progesterone
what is WHO’s advice on breastfeeding ?
exclusively breastfeed fro first 6 months and add solids+ breast milk for up to 2 years or as long as mother chooses
what common organisms cause infective mastitis
staph aureus
then co ag post staph
what is the most common non infective cause of mastitis and what is it ?
duct ectasia - blocked lactiferous duct
where in the breast are abscesses related to breast feeding most common
peripheral breast
where are abscesses unrelated to breast feeding likely to be seen
sub -areolar
should breast feeding continue in mastitis ?
yes
treatment for mastitis
flucloxacillin 500mg PO
what is classed as a minor PPH
500ml-1L
what is classed as a major PPH
> 1L or CV collapse or ongoing bleeding
causes of PPH
tone - atony
trauma - vag tear
tissue -retained products of conception
thrombin- coagulopathy
what should be adminstered regardless of cause for PPH
tranexamic acid 0.5-1g IV
what non surgical management should be used in uterine atony and tissue
uterine bimanual exam + admin of 5 untits IV syntocinon
catheterise to reduce pressure
if doesnt reslove then
500mg ergometrine, carboprost Im every 5 mins (PG analogue) and misoprostol PR 800mcg
what should be done in PPH when thrombin suspected
remove clots manually
describe a 1st degree perineal tear
skin only
describe a 2nd degree perineal tear
skin and levator ani - usually stitches required
describe a 3rd degree perineal tear
extend to external anal sphincter muscle - may need surgery
when do baby blues occur
day 3 postnatally
puerperal psychosis occurs how many days post natallyy
2 weeks
after how many days post natal does post natal depression occur
2 Weeks
how many umbilical arteries are there ? and veins
2 arteries 1 vein
after birth how long before the foramen ovale closes
minutes
after birth how long before the ductus arteriosus closes
hours
after birth how long before the ductus venosus closes
days
what does APGAR stand for in APGAR score
A- appearance P- pulse G - grimace A - activity R - respiration
what is a normal APGAR score and below what requires immediate resus
7-10
below 3
when is heel prick test performed
ideally 5 days after birthday however eligible up to 1st bday . CF must be done before 8 weeks
