Postpartum Infection and Depression

Question 1

Where is the infection usually occurring?

Other sources of infection

Answer 1

Endometritis

UTIs
Wound infections
Perineal cellulitis
Mastitis

Question 2

What can it progress to if not treated?

Answer 2

Sepsis

Question 3

Risk factors

Answer 3

CS
PROM
Prior chorioamnionitis 
Long labour 
Secondary PPH

Question 4

Endometriosis symptoms:

• Do they have pain?
• What is profound about discharge?
• What about the uterus?

Answer 4

Yes there is lower abdo pain

It is quite offensive discharge

The uterus is usually tender

Question 5

Investigations:

Answer 5

FBC
MSU
Swabs - HSV and wound site
Blood and sputum culture

Question 6

Management

Answer 6

Antibiotics - IV if there are any signs of sepsis

Flucloxacillin PO for mastitis

Question 7

Depression:

How does postnatal depression differ from ‘baby blues’?

What percentage have baby blues?

What percentage go on to have true PND?

What Rx is available for severe PND?

What score can be used to SCREEN for post-natal depression?

Answer 7

PND happens in the 3 months postpartum whereas baby blues is 3-5 days postpartum.

50% of women

10-15% of women

CBT or SSRI

The Edinburg Postnatal Depression Scale