Postpartum complications Flashcards
Define Haematoma
Injury to the blood vessel- usually in the vagina or vulva-
How many mls does a Haematoma generally contain
300-500mls
Treatment for Haematoma
Ice
Analgesia
Surgery ?
Packing
Define subinvolution
Uterus remains large does not involute
Cause of subinvolution
Retained placental fragments, infection
Leukorrhea w backache
Treatment of subinvolution
Oxytocic
Curettage
ABX
Cause of puerprial infection
direct or indirect i.e injury to perineum and exposed tissue or vaginal examinations
Common causative bacteria for puerperal infection
E-Coli Chlamydia Gonocci Staphylocci Streptococci
When does an infection generally start to show signs
anytime between 24 hrs to 10 days after infection begins
Predisposing factors to infection
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
Assessment of Endometritis
Abo Pain Foul smelling discharge Chills Fever Mailaise 30 ^ in WBC
Treatment of Endometritis
FBC Cultures Hygiene IV abx Antipyretics Analgesia Hospital Stay
Treatment of Perinal and CS wounds
Sutures removed Drain purvlent material Abx Analgesics Warm/ Cool compress
Treatment of UTI
Increase fluids
PU frequently
Empty bladder
Urine culture and ABX
What are thromboembolic disorders
Blood clot formed from impeded blood flow
cause of thromboembolism
hypercoaguability of blood
venous stasis
Injury to epithelium of vessels
Prevention of Thromboembolism
Avoid dehydration Avoid trauma to legs i.e in stirrups Early postpartum ambulation Leg exercises no smoking TEDs
Describe superficial thrombophlebitis
occurs 3-4 days post birth
characterised by tenderness local heat, swelling, redness
treated with elevation, local moist heat, analgesia and support stocking
Describe DVT
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
Desribe PE
when the clot moves to the artery
characterised by dyspnea, cough, cyanosis, tachypnea
treatment: pace call, administer 02, narcotics, heparin
What are the phases of wound healing
Haemostasis
Inflammation
Proliferation
Maturation
Describe Haemostasis
Vasoconstrction
Fibrin forms closing wound
Blood or fluid may ooze as a natural mechanism to cleanse the wound
Describe Inflammation
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
Describe proliferation
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
