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2.3.2. Reproductive System > The Postpartum Period > Flashcards

The Postpartum Period Flashcards

1
Q

Define the post-partum period

A

Period from delivery of placenta to 6 weeks

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2
Q

What is involved in post natal care?

A

Midwife visits = <10 days post delivery

Health visitor = assess baby and mum, until 5 years old

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3
Q

What occurs during a post natal examination?

A

~ 6 weeks after delivery

By GP

Mothers mental health, physical health

Assess feeding and behaviour of baby

Urinary, bowel and sexual function

? Anxiety re sexual intercourse

BP, urinalysis, breast, abdo, pelvic/perineal exam = has uterus involuted adequately, has perineal trauma healed?

Contraception discussed

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4
Q

How does the lower genital tract change after delivery

A

Reduction in size of vulva, vagina and cervix

Poor lubrication of vagina

Transformation zone of cervix withdraws into endocervix

Internal os is closed

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5
Q

Why does the lower genital tract change after delivery?

A

Secondary to low oestrogen levels

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6
Q

When will the endometrium be ready for a new bleed?

A

Lactation = ovarian activity suppressed, bleed delayed by several months

No lactation = new by 3/52, 1st period due by 6/52

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7
Q

How does Hb change postpartum?

A

Increased

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8
Q

Desribe the WBC levels postpartum?

A

Very high immediately postpartum

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9
Q

How does platelet count change postpartum?

A

Rises back to non-preg levels

After caesarean delivery it may rise to high levels

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10
Q

How does serum, ferritin, transferrin and iron change postpartum?

A

Significantly low before delivery

Return to normal 5-8 weeks

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11
Q

How do LFTs change postpartum?

A

Increase after delivery

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12
Q

How does plasma cholesterol change postpartum?

A

Very high before delivery

Return to non-preg levels over many months

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13
Q

How does prolactin levels change postpartum?

A

Remain high for 2-3 weeks, then drop to normal

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14
Q

How does thyroxine levels change postpartum?

A

Return to non-preg state by 6 weeks

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15
Q

Briefly outline the postnatal ‘high’

A

Positive feelings

Satisfaction

Increased closeness to partner/mother

Gradual ‘falling in love’ with baby

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16
Q

What -ve feeling may the mother feel when postpartum?

A

Anxiety about baby

Disappointment/distress over delivery

rejection or ambivalence about the baby

jealousy about the baby being the centre of attention

fears of harming the baby

Overwhelming responsibility

17
Q

What causes hypertrophy of the pre-existing alveolar-lobular breasts?

A

Progesterone, oestrogen, prolactin, GH, adrenal steroids

18
Q

What inhibits milk product during preg?

A

Oestrogen and progesterone

19
Q

What triggers prolactin release?

A

Action of suckling at the nipple

20
Q

What effect does oxytocin have on the breast?

A

Contraction of myoepithelial cells situated around the alveolae = expel milk into milk-collecting ducts

21
Q

What is colostrum?

A

First secretion from the mammary glands after birth

High fat content

High Igs

22
Q

What are the components of breast milk?

A

has a much lower salt content

has a higher energy content

has less protein

has more lactose

is more digestible by the human baby

23
Q

Outline the functions of breast milk

A

Food/nutrients for first 6 months

Lactoferrin = bind iron preventing proliferation of e.coli

Bactericidal enzymes

Lymphocytes = cell mediated immunity

IgA

24
Q

Which immunoglobulin is transmitted via breast milk?

A

IgA

25
Q

Describe problems that may result from breast feeding

A

Nipple sensitivity and pain

Engorgement

Mastitis

Breast abscess

Breast lumps- benign or malignant

Breast lump must always be investigated

Self-examination- outside menstruation

26
Q

Define puerperium

A

Period of ~6 weeks postpartum

Mothers reproductive organs return to original non-preg condition

27
Q

Outline some possible problems of puerperium

A

Postpartum haemorrhage (PPH)- primary or secondary

Retained placenta/placental tissue

Uterine inversion

Perineal trauma and sequelae

Maternal collapse

Cardiac arrest

Thromboembolic disease

Puerperal pyrexia/sepsis- sources; genital tract; urinary tract; lactation ducts

28
Q

Define postpartum haemorrhage

A

Loss of more then >500ml of blood within the first 24hrs following childbirth

29
Q

What is the most common cause of postpartum haemorrhage?

A

70% uterine artery

Inability of uterus to contract may lead to continous bleeding

Retained placental tissue and infection may contribute

30
Q

What is postpartum depression?

A

Mood disorder – symptoms similar to depression outside of preg

Symptoms occur within 4/52 of delivery

31
Q

Describe puerperal psychosis

A

Symptoms = anxiety, mania, paranoid thoughts, delusions

Raises suicide and infanticide risk

32
Q

Define dyspareunia

A

Difficult/painful sexual intercourse

Due to = low oestrogen and other causes

2.3.2. Reproductive System (20 decks)

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