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Obstetrics and Gynaecology > Post-partum > Flashcards

Flashcards in Post-partum Deck (8)
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1
Q

Define early vs late PPH

A

Early - blood loss of greater than 500mL within 24 hours of delivery

Late - blood loss of greater than 500 mL after 24h and up to 6/52 postpartum

2
Q

What are the most common causes of early PPH?

A

The 4 Ts

  1. Tone (atony)
  2. Tissue (retained placenta, clots)
  3. Trauma (laceration, inversion)
  4. Thrombin (coagulopathy)
3
Q

What are the most common causes of late PPH?

A

Retained products +/- endometritis

4
Q

List 5 risk factors for endomeritis

A
  1. C/S
  2. Intrapartum chorioamnionitis
  3. Prolonged labour
  4. Prolonged ROM
  5. Multiple vaginal examinations
5
Q

How is endometritis treated?

A

Oral antibiotics if well - cephazolin/metronidazole

6
Q

List 6 broad causes of postpartum pyrexia

A

B-5W

Breast: engorgement, mastitis
Wind: atelectasis, pneumonia
Water: UTI
Wound: Episiotomy, C/S site infection
Walking: DVT, thrombophlebitis
Womb: endometritis
7
Q

What is the difference between postpartum blues and postpartum depression?

A

Postpartum blues - 85% of new mothers, onset day 3-10, self-limited, should resolve by 2 weeks

Postpartum depression: major depression occurring in a woman within 6 months of childbirth. Suspect if the ‘blues’ last beyond 2 weeks, or if the symptoms in the first two weeks are severe (e.g. extreme disinterest in the baby, suicidal or homicidal/infanticide ideation). Rarely assoc. with postpartum psychosis

8
Q

Describe the different degrees of vaginal tears/lacerations.

A

First degree: involves skin and vaginal mucosa but not underlying fascia and muscle

Second degree: involves fascia and muscles of the perineal body but no the anal sphincter

Third degree: involve the anal sphincter but does not extend through it

Fourth degree: extends through the anal sphincter into the rectal mucosa