Postpartum complications

Question 1

Define Haematoma

Answer 1

Injury to the blood vessel- usually in the vagina or vulva-

Question 2

How many mls does a Haematoma generally contain

Answer 2

300-500mls

Question 3

Treatment for Haematoma

Answer 3

Ice
Analgesia
Surgery ?
Packing

Question 4

Define subinvolution

Answer 4

Uterus remains large does not involute

Question 5

Cause of subinvolution

Answer 5

Retained placental fragments, infection

Leukorrhea w backache

Question 6

Treatment of subinvolution

Answer 6

Oxytocic
Curettage
ABX

Question 7

Cause of puerprial infection

Answer 7

direct or indirect i.e injury to perineum and exposed tissue or vaginal examinations

Question 8

Common causative bacteria for puerperal infection

Answer 8

E-Coli Chlamydia Gonocci Staphylocci Streptococci

Question 9

When does an infection generally start to show signs

Answer 9

anytime between 24 hrs to 10 days after infection begins

Question 10

Predisposing factors to infection

Answer 10

Antenatally- poor nutrition, low SES, Hx of infections, anaemia, immunodeficiency
Intrapartum- prolonged labour, PROM, poor aseptic technique, birth trauma, multiple VEs, Internal monitoring, Episitomy, C section
Postnatal - MROP, Haemorrhage, Retained products

Question 11

Assessment of Endometritis

Answer 11

Abo Pain 
Foul smelling discharge 
Chills 
Fever 
Mailaise 30 ^ in WBC

Question 12

Treatment of Endometritis

Answer 12

FBC 
Cultures 
Hygiene 
IV abx 
Antipyretics 
Analgesia 
Hospital Stay

Question 13

Treatment of Perinal and CS wounds

Answer 13

Sutures removed 
Drain purvlent material 
Abx 
Analgesics 
Warm/ Cool compress

Question 14

Treatment of UTI

Answer 14

Increase fluids
PU frequently
Empty bladder
Urine culture and ABX

Question 15

What are thromboembolic disorders

Answer 15

Blood clot formed from impeded blood flow

Question 16

cause of thromboembolism

Answer 16

hypercoaguability of blood
venous stasis
Injury to epithelium of vessels

Question 17

Prevention of Thromboembolism

Answer 17

Avoid dehydration 
Avoid trauma to legs i.e in stirrups
Early postpartum ambulation 
Leg exercises 
no smoking 
TEDs

Question 18

Describe superficial thrombophlebitis

Answer 18

occurs 3-4 days post birth
characterised by tenderness local heat, swelling, redness
treated with elevation, local moist heat, analgesia and support stocking

Question 19

Describe DVT

Answer 19

occurs 10 to 20 days post birth
characterised by swelling, pain, errythema, heat, oedema, fever, chills, poor turgour
treated with bed rest anlagesia, anticoag therapy, monior for PE, embolism stockings

Question 20

Desribe PE

Answer 20

when the clot moves to the artery
characterised by dyspnea, cough, cyanosis, tachypnea
treatment: pace call, administer 02, narcotics, heparin

Question 21

What are the phases of wound healing

Answer 21

Haemostasis
Inflammation
Proliferation
Maturation

Question 22

Describe Haemostasis

Answer 22

Vasoconstrction
Fibrin forms closing wound
Blood or fluid may ooze as a natural mechanism to cleanse the wound

Question 23

Describe Inflammation

Answer 23

Blood vessels dilate causing erythema, oedema, heat and throbbing
Macrophages clear wound to prepare for new tissue
Epithelial cells move under clot and think layer covers wound

Question 24

Describe proliferation

Answer 24

Granulation- capillaries from surrounding vessels grow into wound bed. Fibrinoblasts produce collagen fibres which connect to tissue to form the edge of the wound
Epithelialisation: new epithelial cells grow whitish pinky colour

Question 25

Name some factors influencing wound healing

Answer 25

Nutrition status 
Smoking 
obesity 
age
diabetes 
corticosteriod
drugs
oxygenation 
wound stress

Question 26

Complications associated with wounds

Answer 26

dehiscence
evisceration
fistula