Session 10 - The Post-Partum Period Flashcards
what is the post partum period
period from delivery of the placenta to 6 weeks after this
the body returns to pre-pregnancy state
when is a post-natal examination performed
6 weeks by the mothers GP
what is lochia
post partum bleedig
what are the oestrogen levels like post partum
low
when does menstruation return
6 weeks postpartum if not breastfeeding if so then can be delayed by sevral months
describe the structure of the lactating breas
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
what can inadequate uterine contraction lead to
postpartum haemorrhage
what are teh causes of PPH
tone- atony
tissue- retained placenta
thrombin- clotting disorder
trauma
what are the postnatal blues
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
when does postpartum depression occur
within 4 weeks of delivery
what is puerperal psychosis
occurs withinn 4 weeks of delivery
severe anxiety
mania
paranoid thoughts
delusions
what influences full development of the breast
oestradiol
progesterone
gradual increase in prolactin
hPL
hormones which affect the breast are…
mamogenic
lactogenic
galactokinetic
galactopoietic
what is mammogenic
promote proliferation of alveolar and duct cells
what is lactogenic
promote initiation of milk production
what is galactokinetic
promote contraction of myoepithelial cells
what is galactopoietic
maintain milk production
what is a powerful stimulus for PRL release
sucklung
how is inhibition of PRL release orevented
suckling stimulates nueones from the spinal cord to inhibit dopamine release which normally inhibits PRL release from the anterior pituitary
what is the let doen reflex
neurones from the spinal cord stimulate oxytocin release which causes mypepithelial cells to contract and eject milk
how does breast milk protect the baby
lactoferrin populates neonatal gut with non-pathogenic flora presence of bacteriocidal enzymes contains specific immunoglobulins contains lymphocytes and granulocytes
puerperal mastitis
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
what is the most lily infective agent in puerperal mastotis is infective
staphylococcus aureus
how does cessation of lactation occur
milk accumulates in the alveol of the breast causing distention and atrophy of the glandular epithelium
what can be given artifically to supress lactation
dopamine agonists
what hormone is responsible for milk ejection
oxyoci
what hormone is responsible for milk secretion
prolactin
what hormonal change is responsible for the secretion of milk after delivery
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
