Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Reproductive systems > The post-partum period > Flashcards

The post-partum period Flashcards

1
Q

How long does the post partum period last?

A
  • From delivery of placenta until 6 weeks after giving birth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define the post partum period

A
  • Period when changes that occurred as a result of pregnancy revert to the pre-pregnancy state
  • Period of great changes/modifications in lifestyle, psychology, activities, relationships, responsibility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What happens during the post partum period?

A
  • Step-down of medical input if any required during pregnancy
  • Potential for problem to occur
  • Continue optimal management of any pre-existing medical conditions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How is a new mum looked after?

A
  • Post-natal care is initially provided at home by community midwife
  • Provide advice on contraception, breast feeding, and checking episiotomy healing
  • Health visitor then takes over - visits mother at home and mother attends weekly clinics until baby is 6 weeks old
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the role of the health visitor in the post partum period?

A
  • Offer support to mother
  • Assess baby’s health e.g. advising on immunisations
  • Assess baby’s development e.g. weight gain and milestones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Outline what questions should be asked in a post-natal examination

A
  • 6 weeks post partum
  • Normally done by GP
  • Assess mother-infant interaction
  • Assess woman’s mental and physical health
  • Assess feeding and behaviour of baby
  • Ask questions about urinary, bowel and sexual function, as well as incontinence
  • Ask about dyspareunia and anxiety about sexual intercourse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What examinations/tests should be done in a post-natal examination?

A
  • Blood pressure and urinalysis
  • General, breast, abdominal and pelvic/perineal exam
  • Cervical smear
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What needs to be discussed with the patient in a post-natal examination?

A
  • Contraception
  • Excellent opportunity to discuss adjustment to parenthood and any anxieties
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What physiological and anatomical changes occur to the lower genital tract following birth?

A
  • Secondary to low oestrogen levels
  • Reduction in size of vulva, vagina and cervix
  • Poor lubrication of vagina
  • Transformation zone of cervix withdraws into endocervix
  • Internal os is closed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Outline how bleeding occurs following birth

A
  • Initially heavy flow
  • Flow gradually reduces
  • Menstruation usually returns by 6th week post partum
  • Unless mother is breast feeding - then menses is delayed by several months
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What other changes occur following birth?

A
  • Ligament laxity resolves
  • Cardiovascular function returns to normal 6 weeks post partum
  • Skeletal muscle changes
  • Endocrine changes
  • Haematological changes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What psychological changes occur during the post partum period?

A
  • Elation
  • Protectiveness
  • Anxiety
  • Overwhelming responsibility
  • Rejection of the baby
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Give an overview of the lactating breast

A
  • Consists of a series of secretory lobules
  • These empty into ductules
  • Ductules from 15-20 lobules combine into a duct which widens at the ampulla
  • Lactiferous duct carries secretions to the outside
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does postpartum haemorrhage occur?

A
  • If inadequate uterine contraction occurs after delivery
  • PPH is an obstetric emergency and needs urgent management
  • Prevents major blood loss and cardiovascular shock
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What can follow on from post partum haemorrhage?

A
  • Secondary haemorrhage can occur
  • Typically presents in primary care as prolonged or excessive bleeding once the mother has returned home
  • Typically caused by infection (endometritis) and/or retained products of conception
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the causes of PPH?

A
  • 4 Ts
  • Tone (atony)
  • Tissue (e.g. retained placenta)
  • Thrombin (clotting disorder)
  • Trauma
17
Q

What are some common problems of the post partum period?

A
  • Haemorrhage (primary or secondary)
  • Retained placenta/placental tissue
  • Uterine inversion
  • Perineal trauma
  • Maternal collapse/cardiac arrest
  • Thromboembolic disease
  • Pyrexia/sepsis
  • Mental health problems
18
Q

What can retained placenta/placental tissue lead to?

A
  • Infection
  • Bleeding
19
Q

What is uterine inversion?

A
  • Uterus turns inside out
  • Occurs when delivering placenta
  • Obstetric emergency
20
Q

What kind of perineal trauma can occur while giving birth?

A
  • Bruises/tears
  • Sequelae (e.g. involving perineal body and anal sphincter)
21
Q

What can cause maternal collapse/cardiac arrest?

A
  • Amniotic fluid embolism
  • Hypoglycaemia
  • Hypotension/hypovolaemia
22
Q

What are the risk factors for new mums developing thromboembolic disease?

A
  • Surgery
  • Obesity
  • Having just has a baby
  • Immobility
23
Q

What can allow pyrexia or sepsis can occur in new mothers?

A
  • Genital tract
  • Urinary tract
  • Lactation ducts
24
Q

Outline the postnatal blues

A
  • Common after delivery
  • Refers to altered mood caused by hormonal changes
  • Mother typically feels more tearful or anxious
  • Normal up to 2 weeks after delivery
  • Very common
  • Managed by reassurance and support
25
Q

Outline post-partum depression

A
  • Occurs within 4 weeks of delivery
  • Similar symptoms to depression outside of pregnancy
  • Occurs in 13% of women
  • Important to ask as mother may be reluctant to share their feelings
  • Management depends on severity
  • Can be treated pharmacologically if symptoms persist
26
Q

Outline puerperal psychosis

A
  • Usually occurs within 4 weeks of delivery
  • Rare
  • Psychiatric emergency
  • Women with pre-existing mental illness are more at risk
  • Severe symptoms include anxiety, mania, paranoid thoughts, delusions
  • Risk of suicide (5%) and infanticide (4%)
  • Management requires specialist care and pharmacological treatment
27
Q

What other mental illness can arise after birth?

A
  • PTSD
28
Q

What are the characteristics of hormones that affect the breast during lactation?

A
  • Mammogenic (promote proliferation of alveolar and duct cells)
  • Lactogenic (promote initiation of milk production)
  • Galactokinetic (promote proliferation of myoepithelial cells)
  • Galactopoietic (maintain milk production)
29
Q

Outline prolactin production

A
  • Suckling is a powerful stimulation for release
  • Normally release of prolactin from anterior pituitary is inhibited by dopamine
  • Suckling stimulates neurones from spinal cord to inhibit dopamine release
  • PRL levels increase
  • Leads to stimulation of milk production
  • Suckling maintains milk production
30
Q

Outline the role of oxytocin in breastfeeding

A
  • Neurons from spinal cord also stimulate oxytocin release
  • Causes myoepithelial cells contract and eject milk (let-down reflex)
  • Inhibits neurones in arcuate nucleus
  • Levels of GnRH fall
  • Ovarian cycle is inhibited
31
Q

What determines the length of anovulation and amenorrhoea?

A
  • Suckling intensity and frequency
32
Q

What happens to breast milk production initially?

A
  • Milk volumes are low
  • Colostrum is produced, which contains high amounts of fat and immunoglobins
  • As milk production is established, the content changes and 800 ml of milk is produced each day
33
Q

How does breast milk protect the baby from infection?

A
  • Lactoferrin
  • Populates neonatal gut with non-pathogenic flora
  • Presence of bacteriocidal enzymes
  • Contains specific immunoglobulins
  • Contains lymphocytes (mainly T cells) and granulocytes that play a role in cell-mediated immunity
34
Q

What is puerperal mastitis?

A
  • Milk accumulates in the breast and leads to inflammation
  • With or without inflammation
  • Typically occurs if mother only breastfeeds with one breast
  • Milk builds ip in lactiferous ducts of unused breast
35
Q

What organism is responsible for infection in puerperal mastitis?

A
  • Staphylococcus aureus
  • Can lead to abscess formation
36
Q

What is the first line treatment for puerperal mastitis?

A
  • Continue feeding
  • Increase frequency of feeding on affected side
  • Antibiotics can be given if no improvement after 24 hours
37
Q

What happens when lactation stops?

A
  • Milk accumulates in the alveoli of the breast
  • Causes distension and atrophy of glandular epithelium
  • Effects of local mechanical factors suppress milk secretion rather than hormonal changes
38
Q

What drugs can be given to suppress lactation?

A
  • Dopamine agonists e.g. bromocriptine
39
Q

Why is it important to introduce contraception in the post-natal period?

A
  • Family planning following childbirth helps to reduce both maternal and infant deaths
  • Reduces risk of pre-term birth, low birthweight and small-for-gestational age babies

Reproductive systems (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions