Post natal care Flashcards
(31 cards)
How many days before a woman is fertile again after giving birth
21 days
Options for contraception after childbirth 4
- Lactating amenorrhoea - up to 6 months
Progesterone only - safe in breastfeeding and can start at any point after birth (2 days of condoms)
COCP - avoided during breastfeeding
IUS and copper -
What is post partum endometritis
Inflammation of there endometrium, usually due to infection
Px of endometritis
Occurs shortly after birth or several weeks
foul smelling discharge, bleeding that worsens, lower abdominal pain, fever, sepsis
Dx and Mx of endometritis
Ix - Vaginal swabs and urine culture
- US to rule out retained products
Mx - Broad spectrum antibiotics - co-amoxiclav
- sepsis 6
RF for retained products of conception
Placenta accreta**
Px of retained products of conception
Vaginal bleeding that worsens, abnormal discharge, lower abdominal air pelvic pain, fever
Ix of retains products of conception
US 1st choice
Mx of retained products of conception and complications of mx
Surgical removal - dilation and curettage
Complications - Endometritis and Asherman’s syndrome
Asherman’s syndrome
Adhesiosn form within the uterus
Endometrial curettage can damage the endometrial layers - cx scar tissue to form
Complications of asherman’s syndrome
- Scars of uterus can seal uterus leading to infertility
What is post partum anaemia
Hb <100 in post partum period - due to blood loss
Mx of post partum anaemia
FBC checked dat after: PPH>500, c section, antenatal anaemia, symptomatic
Consider individual factors
<100 - oral ferrous sulphate
<90 - iron infusion
<70 - blood transfusion
CI to iron infusion
**Active infection - organisms feed on iron
What is Post partum depression and sx
*Low mood in PP - 1/10 women - peaks around 3 months
Sx - low mood, anhedonia, low energy
Measuring PP depression
Edi post natal scale - 10/30 suggests depression
10 questions
/30
Mx of pp depression
GP help
SSRI and CBT
Secondary input
Baby blues
1/2 women will experience in first week
Sx - mood swings, irritability, anxiety, tearfulness
*Due to hormones, tiredness,…
What casues lactational Mastitis
Common complication of breast feeding
Cx - Inflammation or infection caused by staph
Sx and Mx of lactational mastitis
Sx - painful breast, tender, hot, red, pain when breast feeding, fever, discharge
Ix - clinical diagnosis
Mx - 1st line - keep breast feeding, breast massage, hot packs
- flucloxacillin or erythromycin
Complications of mastitis
Candida of the nipple - post AB course
- can causes recurrence due to cracked skin
Sx - sore nipples, cracked skin, white mouth and tongue in baby
Mx of candida
*Mother and baby need treatment
Topical miconazole after breast feed - breast
Miconazole gel or nysatin - baby
Post partum thyroiditis stages
- Changes occur witihin 12 months of delivery
Stage 1- thyrotoxicosis (3 months)
Stage 2 - Hypothyroid (3-6 months)
Stage 3 - Thyroid returns to normal (within 1 year)
mx of pp thyroiditis
Sx control thyrotoxicosis - propanolol
Hypo - levothyroxine
