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ENRP > Postpartum Hemorrhage/Fever > Flashcards

Postpartum Hemorrhage/Fever Flashcards

1
Q

What is the leading cause of maternal death?

A

Postpartum hemorrhage

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2
Q

With a vaginal birth, what defines a postpartum hemorrhage?

A

> 500 cc blood lost

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3
Q

With a C-section, what defines a postpartum hemorrhage?

A

> 1000 cc blood lost

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4
Q

Primary Postpartum Hemorrhages occur when?

A

Within the 1st 24 hours after delivery

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5
Q

Secondary Postpartum Hemorrhages occur when?

A

After 24 hours up to 12 weeks

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6
Q

What is the most common cause of Primary Postpartum Hemorrhages?

A

Uterine Atony

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7
Q

What is Uterine Atony?

A

Uterus fails to contract after the delivery of the baby or placenta in order to compress the severed vessels

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8
Q

What is Uterine Atony?

A

Uterus fails to contract after the delivery of the baby or placenta in order to compress the severed vessels

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9
Q

On palpation, what will be felt with Uterine Atony?

A

Boggy uterus

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10
Q

If you feel a boggy uterus after the delivery of the baby/placenta, what is likely the cause?

A

Uterine Atony

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11
Q

What is the treatment of Uterine Atony?

A

Bimanual massage of the uterus + pharmacologic interventions

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12
Q

What is the treatment of Uterine Atony?

A

Bimanual massage of the uterus + pharmacologic methods

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13
Q

A Retained placenta or fragments can also cause Postpartum Hemorrhage. Why is that?

A

Uterus cannot maintain contraction and involute normally with the retained products

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14
Q

If the uterus cannot maintain contraction and involute normally, what is likely in the way?

A

Retained Placental fragments

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15
Q

What is the treatment for a Retained Placenta?

A

Manual Removal +/- uterine curettage

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16
Q

What is a Uterine Inversion?

A

Uterine fundus descends downward

17
Q

What often can cause Uterine Inversion?

A

Improper management of the 3rd stage of labor

18
Q

What is the proper management of the 3rd stage of labor in order to avoid a Uterine Inversion?

A

Counterpressure between the symphysis and fundus!

19
Q

If the Uterine inversion occurs before the placenta is delivered, what should you do first?

A

Fix the uterine inversion

20
Q

How do you treat a Uterine Inversion?

A

Manually replace the uterus + start Oxytocin

21
Q

What is Febrile Morbidity?

A

Fever for 2+ days during the first 10 days after delivery

22
Q

What usually causes Febrile Morbidity?

A

Endometritis

23
Q

After delivery, what happens to the pH of the vagina that can allow organism growth?

A

pH becomes more alkaline

24
Q

Puerperal Sepsis occurs after the delivery of the baby What organisms are usually to blame?

A

Anaerobic Cocci

25
Q

Puerperal Sepsis occurs after the delivery of the baby. What organisms are usually to blame?

A

Anaerobic Cocci

26
Q

What are the signs of Puerperal Sepsis?

A

Postpartum FEVER and uterine tenderness 2-3 days after delivery

27
Q

What are the signs of Puerperal Sepsis?

A

Postpartum FEVER and uterine tenderness 2-3 days after delivery

28
Q

What is the treatment for Puerperal Sepsis?

A

Antibiotics with Anaerobic coverage

29
Q

What is a pathogen that can be resistant to the broad spectrum antibiotics with Puerperal Sepsis?

A

Bacteroides Fragilis

30
Q

If the postpartum fever is persistent after the antibiotics, what are 2 causes you must consider?

A

Ovarian Vein Thrombophlebitis

Deep Septic Pelvic Vein Thrombophlebitis

31
Q

Ovarian Vein and Deep Septic Pelvic Vein Thrombophlebitis’ occur a few days after delivery. How does the patient appear with each?

A

Ovarian Vein = APPEAR ILL

Deep Septic Pelvic Vein = do NOT appear ill

32
Q

If a postpartum mother has a fever a few days after birth and she appears ill, what may be seen on radiographics?

A

Ovarian Vein Thrombosis may be seen

33
Q

If a postpartum mother has a fever that is not responding to medications a few days after giving birth but she appears fine, what will be seen on radiographs?

A

NOTHING

– deep septic pelvic vein thrombophlebitis

34
Q

What is the treatment for both Ovarian Vein and Deep Septic Pelvic Vein Thrombophlebitis’?

A

Anticoagulate

35
Q

2-3 days postpartum with a fever and uterine tenderness, what should you consider is likely?

A

Puerperal Sepsis

ENRP (45 decks)

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