The Post-Partum Period Flashcards
What is the Post-Partum Period?
Period from delivery of Placenta to 6 Weeks after this
Body returns to a pre-pregnant state
Initially, how is post-natal care done?
Initially provided at home by a midwife
After the fist few weeks, a health visitor takes over including an initial visit to mother at home
After the health visitor takes over, how often are mother encouraged to attend specific clinics with thei babies?
Once a week until 6 weeks of age
After this, attendance at the clinic decreases with age of child, but continues until age of 5
When is a post-natal examination performed? By who?
What are 4 things assessed here?
At 6 weeks, usually by mother’s GP
- Blood Pressure
- Breast, Ab, Pelvic, Perineal examinations
- Mental health
- Adjustment to motherhood
The Post-Partum Period is characterised by low Oestrogen levels and changes to multiple systems. (Lower genital, Endocrine, Haematological, CVS, MSK)
What is Iochia? How does it change as time progresses?
Iochia: Bleeding Post-Partum Period
It gradually reduces, with only 10% of women still bleeding at 6 weeks
When does Menstruation return in the Post-Partum Period?
- Usually by week 6, if not breast-feeding
- Can be delayed by several months in nursing mothers
List some psychological changes that can be seen in the Post-Partum Period
- Elation
- Protectiveness
- Anxiety
- Overhwelming responsibility
- Rejection of baby
Describe the structure of the breast
- Consists of Secretory Lobules which empty into Ductules
- Ductules from 15-20 Lobules combine into a duct, which widens at the Ampulla (a small reservoir)
- Lactiferous Duct carries secretions to the outside
Suggest a potentially fatal condition that can be caused by inadequate uterine contraction
Post-Partum Haemorrhage (PPH)
It is an emergency and needs urgent management
List 4 causes of PPH
‘The 4 Ts’
- Tone
- Tissue (retained placenta)
- Thrombin (clotting disorder)
- Trauma
List 8 complications that occur during the Post-Partum Period
- Haemorrhage
- Retained placenta/ placental tissue
- Uterine inversion
- Perineal trauma
- Maternal collapse/ cardiac arrest
- Thromboembolic disease
- Pyrexia/ Sepsis
- Mental health problems
List 4 mental health problems that can occur during the Post-Partum Period.
- Postnatal blues (Baby blues)
- Post-Partum Depression
- Puerperal Psychosis
- PTSD (in 1.5% of women, psychological therapies)
Describe Postnatal/ Baby Blues
When does it peak?
(Managed by support and reassurance)
- Common, considered normal up to 2 weeks after delivery
- Altered mood due to hormonal changes
- Mother feels more tearful or anxious
- Peaks at day 4/5
Describe Post-Partum Depression
(Important to ask about as mothers may be reluctant to share that they’re feeling depressed)
When can pharmacological managements be started?
- Occurs within 4 weeks of delivery, and in 13% of women
- If symptoms last longer than a month
Describe Puerperal Psychosis (Considered a psychiatric emergency)
- Rare, occurs within 4 weeks of delivery
- 30% of cases in women with a pre-existing mental illness
- Specialist care, mainly pharmacological
