postpartum complications Flashcards
clinical manifestations for perinatal depression?
symptoms that last for > 2 weeks
treatment for perinatal depression?
- antidepressants SSRIs eg fluoxetine
- norepinephrine reuptake inhibitors SNRIs eg venlafaxine
risk factors of PPH?
- prolonged delivery
- C-sect delivery
- Hx of PPH
- placental disorders
- overdistended uterus due to polyhydramnios, multiple gestation or macrosomic infant
- infection
cause of PPH?
4 Ts
1. tone (uterine atony)
2. trauma (damage to reproductive organs eg ovary)
3. tissue (placental fragments remain)
4. thrombin (Von Willebrand - condition where blood clots are unable to form)
clinical manifestations of PPH?
- boggy, soft uterus
- perineal pad filled with blood in < 1h (vaginal birth >500ml; c-sect >1L)
- blood clots
what does overt mean?
large amts of blood lost
what does occult mean?
blood pools up in the body or haematoma in uterus/ abdominal cavity
treatment for PPH?
- bimanual uterine massage
- oxytocin
for severe cases, - intrauterine balloon tamponade (balloon compresses blood vessels)
- uterine artery ligation (block blood vessels)
- hysterectomy
nursing mgmt for PPH pts?
- massage (ctrl bleeding)
- elevate legs 30 degrees
- IV fluids
- monitor i/p & o/p for indwelling catheter
- vital signs
explain placenta previa
placenta at the lower part of the uterus, blocking the cervix (previa- exit)
explain placenta accreta
placenta attaches too deeply and cannot separate from the uterine lining after delivery
explain placental abruption
placenta partly or completely separates from the uterine lining before delivery
what is mastitis?
inflammation of breast tissue (due to clogged milk ducts & inadequate milk emptying)
what is chorioamnionitis?
inflammation of amniotic fluid (caused by ascending infection)
what is endometritis?
inflammation of endometrium
what is myometritis?
inflammation of myometrium
what is peritonitis?
inflammation of peritoneum
what other infections can endometritis result in?
salpingitis (fallopian tube)
oophoritis (ovaries)
what is cystitis?
inflammation of bladder
what infection can cystitis result in?
pylonephritis (inflammation of kidneys)
what are the complications of UTI?
by ascending infection,
it can cause endometritis, myometritis, salpingitis, oophoritis, peritonitis, cystitis, pylonephritis
what is dysuria?
pain when urinating
what are the clinical manifestations of postpartum infections?
fever > 38C, malaise (feeling of discomfort), loss of appetite, tachycardia
1. endometritis - abdominal pain, foul-smelling discharge, uterine involution
2. septic pelvic thrombophlebitis - abdominal/ flank pain
3. wound - swelling, discharge, pus
4. mastitis - hard lumps, redness
5. UTI - dysuria, foul-smelling urine
postpartum infections?
mastitis, UTI and septic pelvic thrombophlebitis
what is septic pelvic thrombophlebitis?
inflammation of septic vein caused by blood clots
what are the complications of septic pelvic thrombophlebitis?
septic shock which can result in death
what are the clinical manifestations of septic pelvic thrombophlebitis?
abdominal/ flank pain
what is the diagnosis for septic pelvic thrombophlebitis?
coagulation studies
what is the treatment for septic pelvic thrombophlebitis?
anticoagulants
what is necrotising fasciitis?
severe wound infection
what is the cause of postpartum infections?
anaerobic & aerobic bacteria
what does iatrogenic mean?
relating to illness caused by a medical exam
