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Women's Health > postpartum care > Flashcards

postpartum care Flashcards

1
Q

What is endometritis?

A

Poly microbial infection of the endometrium with bacteria from the lower genital tract.
!!! Most common postpartum infection!!!

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2
Q

What are some pathogen known to cause endometritis?

A

Group A & B streptocci

Chlamydia & gonorrhea can also cause it

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3
Q

What is the presentation of endometritis?

A

Foul smelling vaginal bleeding or discharge
Fever
uterine tenderness
Tachycardia

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4
Q

What are alarm findings for endometritis?

A

Fever >103 F

OR

Fever >102 +
-HR >110
-RR >20
WBC with 10% band
BP <90/60

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5
Q

What is the gold standard tx for endometritis?

A

Clindamycin + Gentamicin (+/- ampicillin or augmentin if GBS +)

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6
Q

How is pernieal laceration different from episiotomy?

A

perineal laceration is a tear of the skin of the perineum with vaginal child birth.

Episiotomy: intentional incision of the perineum to aid with facilitation of delivery.

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7
Q

1st degree perineal laceration?

A

lacerations extend to the skin and subcutaneous tissue of the perineum, and the perineal muscles are intact

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8
Q

2nd degree perineal laceration?

A

lacerations extend through the fascia into the muscle of the perineum but leave the anal sphincter muscles intact.

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9
Q

3rd degree perineal laceration ?

A

extend through the fascia and perineal muscles and into the anal sphincter.

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10
Q

4th degree perineal laceration

A

extend through the perineal muscles, external and internal anal sphincters, and the rectal mucosa

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11
Q

what is the most common type of episiotomy?

A

midline and mediolateral

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12
Q

What is puerperium and how long does it last?

A

period after birth in which the reproductive tract and body returns to its non pregnant state.
generally lasts 6 weeks

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13
Q

What is the course of normal postpartum discharge?

A

Lochia rubra: mense like bleeding with blood & necrotic decidual tissue

Lochia serosa: lighter discharge with less blood (mucopurulent and may have a mild odor)

Lochia Alba: yellow-whitish discharge (may persist for 7wks)

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14
Q

What is the size of the cervix by wk1 of the pueperium?

A

at the end of the first week, it is little more than 1 cm dilated

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15
Q

How long does it take for the uterus to involute completely?

A

Within 2 weeks of delivery the uterus should be approximately at the level of the pelvis. By 6 weeks post partum, it should be normal size.

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16
Q

How long are patients amenorrheic after delivery?

A

Lactating women = increase prolactin levels = ovulation suppression.

nonlactating: 70-75 days (2 months)
Lactating: 6 months

17
Q

Why does postpartum ovulation suppression occur?

A

Ovulation suppression is related to elevated prolactin and decreased estrogen levels.

Lactating women: increased prolactin lasts 6 weeks & estrogen levels remain low.

Nonlactating women: prolactin normalizes by postpartum week 3 and estrogen rises

18
Q

What is the definition of a postpartum fever?

A

A temperature of 100.4° F x2 separate occasions, more than 24 hours after delivery.

19
Q

What is septic pelvic thrombophlebitis?

A

A complication of endometritis of when a thrombus in the pelvic vein gets infected.

Postpartum endometritis not improved with abx

Will need heparin added to gentamicin & clindamycin

20
Q

What is postpartum hemorrhage?

A

bleeding >500 ml vaginal
>1000ml c-section

21
Q

What are the 4 T’s of postpartum hemorrhage?

A

Tone: Atony “soft & boggy” uterus (MCC)
Trauma: laceration to cervix & vagina
Thrombin: underlying coagulation disorder
Tissue: retained placenta

22
Q

What is the treatment of atony?

A

uterine massage & oxytocin

23
Q

What is a common lab finding of von willebrand disease?

A

increase PTT
normal PT
normal platelets
abnormal ristocetin

24
Q

What is a complication of postpartum hemorrhage ?

A

the pituitary gland enlarge during pregnancy -> prone to infraction with hypovolemia

25
Q

What is the presentation of sheehan syndrome?

A

failure to lactate + ameorrhea

26
Q

The uterus involutes progressively after 5-7 days and should be firm, nontender & located between

A

symphysis & umbilicus

27
Q

Postpartum blues is common during the first__________ hours after delivery but is transient.

A

ostpartum blues is common during the first 24–72 hours after delivery but is transient.

28
Q

When can a patient with vaginal delivery return to sexual activity?

A

As soon as the woman feels ready after a minimum of 2 weeks

29
Q

What are the three components of the levator ani muscle?

A

The puborectalis, pubococcygeus, and iliococcygeus. These form the pelvic floor.

30
Q

What are the components ofcolostrum?

A

immunoglobulin (IgA)
leukocytes, marcophages
high protein -> high lactoferrin

Women's Health (12 decks)

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