Postpartum Care and Complications

Question 1

Common causes of postpartum hemorrhage (5):

Answer 1

• Uterine atony (most common)
• Retained products of conception
• Placenta accreta
• Cervical/vaginal lacerations
• Uterine rupture

Question 2

Hypovolemia and hypotension with absence of lactation:

Answer 2

Sheehan syndrome (pituitary infarct)

Question 3

Uterine atony: diagnosis, management

Answer 3

• Palpation: soft, enlarged, boggy
• Oxytocin, Methergine, Hemabate
• D&C for r/o POC
• Inflamtable tamponade, embolization

Question 4

Endomyometritis: diagnosis, suspicion, treatment

Answer 4

• Fever, ^WBC, uterine tenderness
• Suspect after c-section
• Tx: broad-spectrum abx until AF x 48h, minimal pain, and normal WBC

Question 5

Cellulitis not responding to abx with increasing fever or pus from wound:

Answer 5

Wound abscess

Question 6

Sign of progression of cellulitis to nec fasc:

Answer 6

Loss of pain from cellulitis injuring nerve(s) without change in visual appearance

Question 7

Mastitis: diagnosis, management

Answer 7

• B/l warm, tender, firm breasts
• Tx: oral abx (dicloxacillin, 10-14d)
• Encourage breastfeeding/pumping