Postpartum Care Flashcards
what is inflamation of the endometrium, which is the inner lining of the uterus
endometritis
what is the most common cause of infection after childbirth
endometritis
what are symptoms of endometritis
fever
lower abdominal pain
abnormal vaginal bleeding or discharge
what are risk of endometritis
c-section
PROM
vaginal delivery
D&C
pelvic exams
how is endometritis diagnosed
based on clinical findings
endometrial biopsy can help make the dx
what is the treatment of endometritis
involves the use of abx
- clindamycin and gentamicin
- dilation and curettage if caused by remaining placental or fetal tissue
what is puerperium
postpartum period
usually lasting 6 weeks
what is immediate puerperium
first 24 hours after parturation when acute postanesthetic or post-delivery complications may occur
what is early puerperium
extends until first week post-partum
what is remote puerperium
includes the period of time required for involution of the genital organs and return of menses, usually approximately 6 weeks
what is a perineal laceration
tear of the skin and other soft tissue structures which, in women, seperates the vagina from the anus
what is an episiotomy
perineum is intentionally incised to facilitate delivery
what is a first degree perineal tear
perineal skin and vaginal mucosa
what is a second degree perineal tear
injury to perneal body
what is a third degree parineal tear
through the external anal sphincter
what is a 4th degree perineal tear
injury through the rectal mucosa
what is the treatment of perineal tears
3rd and 4th degree tears generally require surgical repair
how is postpartum hemorrhage defined
losing >1000ml of blood within first 24 hours after birth
decrease of 10% or more in HCT, changes in mothers HR, BP and O2sat
what are the 4Ts of post partum hemorrhage
Tone, Trauma, Tissue and Thromin
- uterine atony (mc)
- gentital tract trauma
- retained placental tissue
- coagulation disorders (thrombin)
what is uterine atony
boggy and enlarged uterus - 90% of post partum hemorrhages
what is gential tract trauma
precipitious labor, operative vaginal delivery (forcepts, vaccum extraction)
what is the treatment of uterine atony
fundal massage and meds to help the uterus contracts (oxytocin IV, misoprostol)
