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Obstetric And Gynecology > Puerperium and its Disorders > Flashcards

Puerperium and its Disorders Flashcards

1
Q

What is the definition of the puerperium?

A

The period from the delivery of the placenta to the first 6 weeks after delivery.

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2
Q

How long does it take for the uterus to return to its non-pregnant state?

A

It takes approximately 6 weeks.

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3
Q

What is the weight change in the uterus from term pregnancy to 6 weeks postpartum?

A

From 1000g at term to 50-100g at 6 weeks postpartum.

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4
Q

What happens to the cervix during the puerperium?

A

The cervix never returns to its nulliparous state; the external os closes to the extent that a finger cannot be easily introduced.

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5
Q

How soon does ovulation occur postpartum in non-breastfeeding women?

A

As early as 27 days.

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6
Q

What are the three types of lochia, and how do they progress?

A

Lochia rubra (red), lochia serosa (brownish-red), and lochia alba (yellow).

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7
Q

What are the stages of lactation?

A

Mammogenesis, lactogenesis, galactopoiesis, and galactokinesis.

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8
Q

What triggers lactogenesis?

A

Delivery of the placenta triggers lactogenesis.

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9
Q

What happens to prolactin levels in non-breastfeeding women?

A

Prolactin levels decrease and return to normal within 2-3 weeks.

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10
Q

What cardiovascular changes occur during the puerperium?

A

Blood volume returns to non-pregnant levels by the 10th day; cardiac output normalizes by 2-6 weeks.

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11
Q

What are the routine postpartum care measures for vaginal delivery?

A

Includes ice application, routine perineal care, and warm sitz baths after 24 hours.

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12
Q

How is postpartum pain managed after a caesarean delivery?

A

Pain is managed with ice application and systemic pain medications.

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13
Q

When can sexual intercourse typically resume postpartum?

A

Typically resumes after about 3 weeks when the woman is physically and emotionally ready.

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14
Q

What are the key components of general management during puerperium?

A

Monitoring for PPH, uterine involution, lactation establishment, and early ambulation.

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15
Q

Name the two types of postpartum hemorrhage (PPH).

A

Primary and secondary postpartum hemorrhage.

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16
Q

What are the common causes of secondary PPH?

A

Infection, retained placental bits, and uterine subinvolution.

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17
Q

Define puerperal fever.

A

Oral temperature of ≥38°C recorded twice in the first 10 days postpartum (excluding the first 24 hours).

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18
Q

What are the risk factors for puerperal sepsis?

A

Anaemia, malnutrition, prolonged labour, and poor hygiene.

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19
Q

List the immediate complications of puerperal sepsis.

A

Septicaemia, septic shock, DIC, pulmonary embolism, kidney failure, and death.

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20
Q

What is the commonest puerperal psychiatric disorder?

A

Puerperal blues.

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21
Q

What are the management options for breast engorgement?

A

Firm breast support and analgesics.

22
Q

What is the treatment for cracked nipples?

A

Use of nipple creams and ensuring proper breastfeeding techniques.

23
Q

What are the risk factors for venous thromboembolism (VTE) during puerperium?

A

Increased maternal age, obesity, anemia, dehydration, and reduced mobility.

24
Q

Name the types of puerperal psychiatric disorders.

A

Puerperal blues, depression, and psychosis.

25
Q

What are the preventive measures for puerperal sepsis?

A

Good antenatal, intrapartum, and postnatal care.

26
Q

How is urinary retention managed postpartum?

A

Managed with catheterization.

27
Q

What are the signs of obstetric palsies?

A

Severe neuralgia and foot drop.

28
Q

What is the weight of the uterus immediately postpartum?

A

Approximately 1000g.

29
Q

How long does lochia discharge typically last?

A

Averages about 5 weeks.

30
Q

What is the first type of milk produced after delivery?

A

Colostrum.

31
Q

What changes occur in the hematological system during puerperium?

A

Hemoglobin concentration increases, and clotting factors are elevated.

32
Q

What is the management of perineal swelling postpartum?

A

Ice application and warm sitz baths.

33
Q

Name the six “Ws” causes of puerperal fever.

A

Woman, water, wind, way, wound, wonder drugs.

34
Q

How is postpartum anemia managed?

A

Managed with iron therapy and blood transfusions if necessary.

35
Q

Define secondary postpartum hemorrhage.

A

Hemorrhage occurring after 24 hours to 12 weeks postpartum.

36
Q

What are the differential diagnoses for puerperal sepsis?

A

Endometritis, salpingitis, pelvic cellulitis, pelvic thrombophlebitis, and infected episiotomy.

37
Q

What is the commonest cause of puerperal fever in Nigeria?

A

Malaria.

38
Q

What are the stages of uterine involution?

A

Palpable fundus near the umbilicus postpartum, reduction in size over 6 weeks.

39
Q

What is the significance of prolactin during lactation?

A

Prolactin helps in milk production.

40
Q

How is postpartum fever treated within the first 24 hours?

A

Treated with antipyretics and hydration.

41
Q

What is the role of Anti-D immunoglobulin during puerperium?

A

Prevents Rh sensitization in Rhesus-negative mothers.

42
Q

How much additional caloric intake is recommended for lactating mothers?

A

300 additional calories per day.

43
Q

How long after delivery does cardiac output normalize?

A

By 2-6 weeks postpartum.

44
Q

What exercises are recommended during puerperium?

A

Pelvic floor, abdominal tightening, foot, and leg exercises.

45
Q

What is the commonest presenting feature of obstetric palsies?

A

Foot drop.

46
Q

What are the symptoms of pelvic thrombophlebitis?

A

Pain, swelling, and tenderness in the pelvic region.

47
Q

Name the curative measures for puerperal sepsis.

A

Use of antibiotics and wound care.

48
Q

What are the late complications of puerperal sepsis?

A

Menstrual problems, chronic pelvic pain, and infertility.

49
Q

How is postpartum fatigue managed?

A

Ensuring adequate sleep and hydration.

50
Q

What is the role of early ambulation during puerperium?

A

Prevents venous thromboembolism (VTE) and promotes recovery.

Obstetric And Gynecology (12 decks)

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