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Reproductive System Brian > Postnatal Care > Flashcards

Postnatal Care Flashcards

1
Q

What is the postnatal period also known as?

A

Also known as puerperium, is the first 6 weeks after the baby is born

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2
Q

How often are medical staff seen in standard postnatal care?

A
  • See midwife at home for first 9-10 days, after referred to health visitor
    • Look for signs of abdominal bleeding, infection, mental health issues
  • 6 week postnatal check at GP
    • Contraception, mental health/general wellbeing
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3
Q

What are some common problems in the postnatal period?

A
  • Infant feeding
  • Bonding
  • Social issues
    • Partner, other children, financial issues
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4
Q

What are possible complications of breast feeding?

A
  • Mastitis
  • Blocked milk ducts
  • Difficulty feeding/baby latching
  • Skin irritation – “cracked nipples”
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5
Q

What are some key postnatal conditions?

A
  • Post-partum haemorrhage
  • Venous thromboembolism
  • Sepsis
  • Psychiatric disorders of the puerperium
  • Pre-eclampsia
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6
Q

What are the different categories of PPH?

A
  • Primary
    • Blood loss of >500ml within 24 hours of delivery
  • Secondary
    • Blood loss >500ml from 24 hours post partum to 6 weeks
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7
Q

What are risk factors for thromboembolic disease?

A
  • Pregnancy 6-10x more likely
  • Immediately post-partum period is hypercoagulable state
  • Immobilisation following spinal anaesthetic/caesarean section
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8
Q

What is the presentating of thromboembolic disease?

A
  • Unilateral leg swelling and/or pain
  • Shortness of breath
  • Chest pain
  • Tachycardia
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9
Q

What investigations are done for thromboembolic disease?

A
  • D-dimer unreliable in pregnancy
  • ECG
  • Leg dopplers
  • Chest x-ray with or without VQ scan
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10
Q

What investigation, normally used for thromboembolic disease, is not reliable during pregnancy/postnatal?

A

D-dimer

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11
Q

What is the mangement of thromboembolic disease?

A
  • Thromboprophylaxis and risk assessment to avoid
  • Low molecular weight heparin
  • Warfarin is teratogenic, but can be used when breast feeding
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12
Q

What is puerpergal sepsis?

A

Infection of the genital tract occurring at any time between the onset of rupture of membranes or labour, and the 42nd day postpartum

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13
Q

What investigations are done for puerpergal sepsis?

A
  • Perform full septic screen
    • Blood cultures, LVS, MSSU, wound swabs
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14
Q

What is the management of puerpergal sepsis?

A
  • Prompt IV administration – “golden hour”
  • Antipyretic measures
  • IV fluids
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15
Q

What is the incidence of mental health issues postnatally?

A
  • 25% of woman who die between 6 weeks and 1 year after pregnancy died from mental health related causes
    • 1/7 of those is suicide
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16
Q

What team is used to manage postnatal mental health issues?

A

Peri-natal mental health team is used to manage this

17
Q

What are some postnatal mental health issues?

A
  • Baby blues
  • Postnatal depression
  • Puerperal psychosis
18
Q

What is the aetiology of baby blues?

A
  • Affects most woman due to hormonal changes around the time of birth
19
Q

What is the management of baby blues?

A
  • No specific treatment as does not affect functioning
20
Q

When can postnatal depression continue from?

A

Can continue from baby blue or start sometime later

21
Q

What are risk factors for postnatal depression?

A
  • Personal or family history of affective disorder
22
Q

What is the presentation of postnatal depression?

A
  • Classical depressive symptoms
  • Affects functioning and bonding, requiring treatment
23
Q

What is puerperal psychosis?

A

Mental disorder occurring after childbirth, characterised by deep depression, delusions of childs death and homicidal feelings towards child

24
Q

What are risk factors for puerperal psychosis?

A
  • Personal or family history of affective disorder, bipolar disorder or psychosis
25
Q

Is the incidence of puerperal psychosis common or rare?

A

Rare

26
Q

What is the management of puerperal psychosis?

A
  • Inpatient psychiatric care
  • Woman is a danger to themselves and their baby
27
Q

What is pre-eclampsia?

A

Pre-eclampsia = causes hypertension during pregnancy and after labour

28
Q

What is the management of pre-eclampsia?

A
  • Discharge on antihypertensive
  • Follow up in community

Reproductive System Brian (34 decks)

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