Postnatal check

Question 1

Important information to gather

Answer 1

General well being
Breast feeding
Coping with baby, mood
Contraception
Perineal, abomen
Bowel and bladder
Pap smear
Obstetric 
Gynaecological
Past medical history
Family
Social

Question 2

Examination

Answer 2

General
Blood pressure
Abdominal examination->check involution of uterus
Vaginal examination if required

Question 3

If post-natal woman on progesterone pill complains of dysparaneuria, what should you consider and look for, and recommendations?

Answer 3

The relative low estrogen state of post natal and progesterone pill-> atrophic vaginitis.
Can use estrogen cream twice a week.

Question 4

When can transition to COCP be done

Answer 4

Weaning from breast feeding

Question 5

Advice about progesterone only pill

Answer 5

Thins endometrium
Thick cervical mucus
Altered fallopian tube transport
Inhibits sperm motility and implantation

Question 6

Advice about the etonogestrel implant

Answer 6

Plastic rod inserted by practitioner. Lasts for 3 years. Releases steady dose of etonogestrel which inhibits LH->early follicular development and estrogen production occurs, but without ovulation. PI of 0.09
Most women become amenorrheoic but some will have irregular and unpredictable bleeding