Session 10 - The Post-Partum Period

Question 1

what is the post partum period

Answer 1

period from delivery of the placenta to 6 weeks after this

the body returns to pre-pregnancy state

Question 2

when is a post-natal examination performed

Answer 2

6 weeks by the mothers GP

Question 3

what is lochia

Answer 3

post partum bleedig

Question 4

what are the oestrogen levels like post partum

Answer 4

low

Question 5

when does menstruation return

Answer 5

6 weeks postpartum if not breastfeeding if so then can be delayed by sevral months

Question 6

describe the structure of the lactating breas

Answer 6

a series of secretatory lobules which empty into ductules which combine to form a duct which widens at the ampulla and carries secretions to the outside

Question 7

what can inadequate uterine contraction lead to

Answer 7

postpartum haemorrhage

Question 8

what are teh causes of PPH

Answer 8

tone- atony
tissue- retained placenta
thrombin- clotting disorder
trauma

Question 9

what are the postnatal blues

Answer 9

common after delivery

altered mood experienced due to the hormonal changes that have occured

• mother typically feels more tearful or anxious
• usually peaks ar day 4/5

Question 10

when does postpartum depression occur

Answer 10

within 4 weeks of delivery

Question 11

what is puerperal psychosis

Answer 11

occurs withinn 4 weeks of delivery

severe anxiety
mania
paranoid thoughts
delusions

Question 12

what influences full development of the breast

Answer 12

oestradiol
progesterone
gradual increase in prolactin
hPL

Question 13

hormones which affect the breast are…

Answer 13

mamogenic
lactogenic
galactokinetic
galactopoietic

Question 14

what is mammogenic

Answer 14

promote proliferation of alveolar and duct cells

Question 15

what is lactogenic

Answer 15

promote initiation of milk production

Question 16

what is galactokinetic

Answer 16

promote contraction of myoepithelial cells

Question 17

what is galactopoietic

Answer 17

maintain milk production

Question 18

what is a powerful stimulus for PRL release

Answer 18

sucklung

Question 19

how is inhibition of PRL release orevented

Answer 19

suckling stimulates nueones from the spinal cord to inhibit dopamine release which normally inhibits PRL release from the anterior pituitary

Question 20

what is the let doen reflex

Answer 20

neurones from the spinal cord stimulate oxytocin release which causes mypepithelial cells to contract and eject milk

Question 21

how does breast milk protect the baby

Answer 21

lactoferrin
populates neonatal gut with non-pathogenic flora
presence of bacteriocidal enzymes
contains specific immunoglobulins 
contains lymphocytes and granulocytes

Question 22

puerperal mastitis

Answer 22

a condition where milk accumulation in the breast can lead to inflammation with/ without infection

typically occurs if mother doesnt breats feed wuth both breasts

Question 23

what is the most lily infective agent in puerperal mastotis is infective

Answer 23

staphylococcus aureus

Question 24

how does cessation of lactation occur

Answer 24

milk accumulates in the alveol of the breast causing distention and atrophy of the glandular epithelium

Question 25

what can be given artifically to supress lactation

Answer 25

dopamine agonists

Question 26

what hormone is responsible for milk ejection

Answer 26

oxyoci

Question 27

what hormone is responsible for milk secretion

Answer 27

prolactin

Question 28

what hormonal change is responsible for the secretion of milk after delivery

Answer 28

decreased oestrogen and progesterone

full lactation doesnt occur until after delivery because of the high levels of oestrogen and progesterone of pregnancy inhibit milk secretion rendering the breast tissue unresponsive to prolactin which is rising in concentration as pregnancy proceeds