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Gynaecology and Obstetrics > Puerperium > Flashcards

Puerperium Flashcards

1
Q

Obstetric palsy is AKA

A

traumatic neuritis

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2
Q

What is obstetric palsy?

A

One or both limbs may develop signs of a motor and/or sensory neuropathy following delivery

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3
Q

Cause of obstetric palsy?

A

Compression of lumbosacral trunk as it crosses the sacroiliac joint during descent of fetal head

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4
Q

Presentation of obstetric palsy

A

Sciatic pain
Foot drop
Paresthesia
Hypoesthesia
Muscle wasting

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5
Q

Tx of obstetric palsy

A

Orthopedic opinion
Bed rest
Analgesia
Physiotherapy

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6
Q

Peroneal nerve palsy presents with _________________

A

unilateral foot drop

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7
Q

Secondary postpartum hemorrhage

A

Bleeding from genital tract b/w 24 hours to 6 weeks after delivery

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8
Q

Most common time of Secondary PPH

A

7-14 days

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9
Q

Causes of Secondary PPH

A

Endometritis
Retained placenta

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10
Q

Signs of Endometritis

A

Constant lower abdominal pain
Tender uterus and closed os
Fever and pungent lochia

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11
Q

Signs of Retained placenta

A

Crampy lower abdominal pain
Uterus enlarged and open os
Fever and pungent lochia

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12
Q

What is puerperal pyrexia?

A

Raised temperature (>100.4/>38) on any two days of the first 10 days postpartum, exclusive of 24 hours

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13
Q

Causes of puerperal pyrexia

A

Endometritis (Most common)
Retained placental tissue
Pneumonia, Pulmonary embolism
DVT
Pyelonephritis
Meningitis
Mastitis/Breast Abscess

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14
Q

Puerperal sepsis is ______________

A

polymicrobial

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15
Q

Investigations in puerperal sepsis

A

CBC
UCE
CP
High vaginal swab
Pelvic ultrasound
ABGs

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16
Q

Tx of Puerperal sepsis

A

Cephalosporin
Metronidazole
Clindamycin
IVF
Drainage of pelvic abscess

17
Q

Complications of puerperal sepsis

A

Ascending infection
Necrotizing fascitis of genital tract (clostridium perfringens)
Endometritis
Hematogenous and lymphatic spread

18
Q

Postpartum Pink and Blues
Pink (Euphoric mood) time
Blue (Depressive mood) time

A

Pink time 24-48 hours
Blue time first 2 weeks

19
Q

Postpartum pink and blues management

A

resolves within 10 days
Support

20
Q

Postpartum psychosis is common in week _________ and _____th day

A

within 3 weeks
5th day most common and rarely before 3rd day

21
Q

PPP risk factors

A

Hx of Bipolar/PPP
F Hx of Bipolar/PPP

22
Q

Management of PPP

A

Psychiatric consultation
Lithium
Antidepressants
Acute neuroleptics
ECT
Lithium prophylaxis in high risk patients

23
Q

Postpartum Depression presents in _______th week

A

6th

24
Q

Features of breast milk

A

75 kcal/mL
Whey protein
Polyunsaturated FAs
Safe in children with gastroenteritis
All vitamins except Vitamin K
Iron concentration is low
Iron absorption is high due to lactoferrin

25
Q

WHO recommends breastfeeding for _____ months with the introduction of other foods onwards

A

4-6 months

26
Q

For how long a woman should breastfeed her child?

A

2 years

27
Q

Benefits of breastfeeding

A

Cheap
Readily available at the right temperature
Benefits to country
Reduces illness
Reduces fertility with amenorrhea
Reduces atopic illness
Reduces necrotizing enterocollitis
Reduces Juvenile diabetes
Reduces Cancer
Reduces chances of PPH

28
Q

HIV infected women should not breastfeed if _____________

A

they live in a resource rich setting

29
Q

HIV infected women should breastfeed if they

A

live in poor resources setting

30
Q

Suppression of lactation can be by

A

Cabergoline
Bromocriptine

31
Q

Noninfective vs Infective mastitis causes

A

Noninfective → Restriction of feeding and bad position
Infective → Nipple trauma (S. Aureus/ Streptococcus viridians) from baby’s nose MC or infected umbilical cord

32
Q

Management of noninfective mastitis

A

Continue feeding from the breast
Correct positioning
Ice packs
Analgesia
Avoid compression

33
Q

Management of Infective Mastitis

A

Cease breastfeeding from affected side
Antibiotics
I/D (on US)
Breastfeeding continued)

Gynaecology and Obstetrics (13 decks)

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