session 10- post partum period

Question 1

what is the post partum period

Answer 1

period from delivery of placenta to 6 weeks after

Question 2

structure of lactating breast

Answer 2

secretory lobules, emptying into ductules. 15-20 lobules form a duct, which widens into an ampulla. the lactiferous duct carries the secretion to the outside

Question 3

4 causes of post partum haemorrhage

Answer 3

tone, tissue, thrombin, trauma

Question 4

primary haemorrhage

Answer 4

up to 24 hours

Question 5

secondary haemorrhage

Answer 5

24h-6 weeks

Question 6

causes of maternal collapse/cardiac arrest

Answer 6

amniotic fluid embolism, hypoglycaemia, hypothension

Question 7

risk factors thromboembolic disease

Answer 7

surgery, obesity, recent birth, immobility.

Question 8

when do baby blues peak

Answer 8

4/5 days

Question 9

mammogenic hormones

Answer 9

promote proliferation of alveolar and duct cells

Question 10

lactogenic hormones

Answer 10

promote initiation of milk production

Question 11

galactokinetic hormones

Answer 11

promote contraction of myoepithelial cells

Question 12

galactopoietic hormones

Answer 12

maintain milk production

Question 13

how does suckling cause PRL release

Answer 13

inhibits neurones from spinal cord to inhibit dopamine release, and levels of PRL therefore release. leads to stimulation of milk production

Question 14

what normally inhibits PRL release

Answer 14

dopamine secreting neurones in hypothalamus

Question 15

role of oxytocin

Answer 15

released from neurones in spinal cord, causes myoepithelial cells to contract and eject milk- let down mechanism.

Question 16

how does breast feeding cause amenorrhea

Answer 16

inhibits arcuate and prepoptic neurones, causing GnRH to fall. this inhibits ovarian cycle

Question 17

what is breast milk initially

Answer 17

colostrum, high fat and immunoglobulins.

Question 18

how much milk is produced daily

Answer 18

800ml

Question 19

how does breast milk prevent infection

Answer 19

lactoferrin, non pathogenic flora for gut, bactericidal enzymes, immunoglobulins, T cells and granulocytes for cell mediated immunity

Question 20

puerperal mastitis

Answer 20

accumulation fo milk in breast causing inflammation, caused by not breastfeeding with most breasts.

Question 21

most common organism for breast infection/puerperal mastitis

Answer 21

S aureus.

Question 22

treatment breast infection/puerperal mastitis

Answer 22

continue feeding and increase frequency. antibiotics after 24 hours

Question 23

how to stop lactation

Answer 23

milk accumulates in alveoli of breast, causing distension and atrophy of glandular epithelium. mechanical not hormonal

Question 24

what drugs supress lactation

Answer 24

dopamine agonists eg. bromocriptine