Module 3 - OB Flashcards
Stages of lactogenesis
1 - colostrum
2 - transitional
3 - mature milk comes in
Types of mature milk
foremilk (higher in water)
hindmilk (higher in fat)
baby should BF ~15-20 min each breast to ensure they are getting both types of milk
Lactogenesis Stage 1
begins around 16-18 weeks
colostrum production
Lactogenesis Stage 2
begins after birth/delivery of placaenta
colostrum –> transitional milk
Hormones involved in BF
prolactin = increased milk supply
oxytocin = bonding, uterine contraction
progesterone must decrease before BF can occur
Postpartum infections
mastitis
puerperal infection
endometritis
wound infection
urinary tract infection
puerperal
six weeks after childbirth when mom’s reproductive organs have returned to normal
VTE disorders
superficial VT
DVT
pulmonary embolism
Postpartum structural disorders
uterine displacement/prolapse
cystocele
rectocele
urinary incontinence
GU fistula
Postpartum mood disorders
postpartum depression
postpartum blues
postpartum psychosis
Pathophysiology of pre-eclampsia
incomplete transformation of spiral arteries
upregulation of RAAS by hypoxic placenta
injury to maternal endothelium caused by elevated BP –> intravascular inflammation, platelet and thrombin activation
S/S of pre-eclampsia
BP >140.90
protein +1
elevated serum creatinine
frontal headache/visual disturbance
RUQ
SOB/chest pain
Severe pre-eclampsia
> 160/110
protein +3
HELLP
severe type of pre-eclampsia involving liver injury
usually occurs in last trimester
hypoxic placenta releases cellular debris causing DIC
can be observed 48 hours postpartum
Pathophysiology of HELLP
shearing of RBC as they travel thru damaged blood vessels causing multi-organ damage
elevated liver enzymes caused by damaged hepatocytes –> N/V
low platelet count platelet aggregation + reduced thrombopoietin by liver
