Postnatal Care Flashcards
How long does the postnatal period last? What is another name for it?
The first 6 weeks after the baby is born
Also called the puerperium
Who monitors the mother and baby during the postnatal period? What sort of signs are looked for?
See midwife at home for first 9-10 days, then referred to health visitor. 6 week postnatal check at GP
- Evidence of infection (wound / endometritis / breast)
- Debrief events around birth
- Mental health
Whaat are some of the most common complications of improper prescribing in breast feeding?
- Mastitis (infection of breasts)
- Blocked milk ducts
- Difficulty feeding / baby latching
- Skin irritation (cracked nipples)
What are some of the most important postnatal conditions to remember?
Post partum haemorrhage
Venous thromboembolism
Sepsis
Psychiatric disorders of the puerperium
What are the two types of post partum haemorrhage?
Primary - blood loss of > 500mL within 24h of delivery. Usually due to tears, trauma, tone or thrombin issues
Secondary - blood loss of > 500 mL from 24h post partum to 6 weeks. Usually due to retained tissue, endometritis or tears / trauma
Why are pregnant woman at risk of thromboembolic disease? How long does this last? Treatment?
Because pregnancy is a hypercoaguable state. Lasts 6 weeks after pregnancy
Prophylactic treatment to reduce coagulation (sometimes during, often after pregnancy) - LMWH, or warfarin (warfarin is teratogenic but can be used when breast feeding)
What are some signs that may suggest thromboembolism in a pregnant / post pregnant woman?
- Unilateral leg swelling and / or pain
- SOB or chest pain (PE)
- Tachycardia (PE)
What should you do if you suspect a postnatal woman might in sepsis?
- Prompt IV antibiotic administration
- Perform full sepsis screen: blood cultures, LVS, MSSU, wound swabs
What are two mental health conditions that may be experienced by the mother in the postnatal period?
Postnatal Depression - may continue on from baby blues, has classical depressive symptoms.
Puerperal psychosis - rare psychotic illness of the postnatal period. Requires inpatient psychiatric care as woman can be a danger to themselves & child
Both more common in women with FM of affective disorder
Why is maternal mental health a concern after pregnancy?
Because almost a quarter of women who die between six weeks and one year after pregnancy die from mental health related causes
1 in 7 of these are from suicide
What are some common hypertensive conditions that may affect women in the postnatal period?
- Most preeclamptic seizures occur within the postnatal period
- Pre-eclampsia can develop or may worsen several days following pregnancy
