Postpartum care

Question 1

Definition of postpartum voiding dysfunction

Answer 1

Failure to pass urine spontaneously 6 hours post delivery or catheter removal

Question 2

Incidence. of PP voiding dysfunction

Answer 2

0.7 - 4%

Question 3

Complications if PP voiding dysfx not recognised

Answer 3

Bladder underactivity
Prolonged voiding dysfunction
Recurrent UTIs
Incontinence

Question 4

Risk factors for PP voiding dysfunction

Answer 4

Primip
OVD
Epidural
Prolonged labour
Perineal trauma

Question 5

Types of PP voiding dysfunction

Answer 5

Overt: inability to void
Covert: elevated PVR >150ml w no urinary symptoms

Question 6

Defn PP psychosis

Answer 6

Severe maternal illness with. dramatic onset shortly after childbirth
Mania, severe depression, hallucinations
Onset within 6/52 of delivery

Question 7

Epidemiology of PP psychosis

Answer 7

1-2 per 1000 births
Specific relationship between PP and bipolar disorder
1 in 4 risk suffering recurrence post delivery

Question 8

Aetiology/ pathophysiology PP psychosis

Answer 8

Genetic factors
Obstetric RF:
- primip
- delivery complications
- CS
- female
- shorter gestation period
Medications:
- changes in meds e.g. lithium
Hormonal factors:
- estrogen, progesterone, prolactin, FSH, LH
Sleep deprivation

Question 9

Which patients need debrief post delivery

Answer 9

OVD
VBAC
EmLSCS
Abruption
Shoulders
PPH