Postpartum Care Flashcards
What hormones are decreased by Sheehan Syndrome?
Anterior pituitary: Gonadotropins, TSH, ACTH, prolactin
What is the most common cause of postpartum fever?
Endometritis
What bacteria tend to make up postpartum endometritis?
Staph, Strep, polymicrobial mix of aerobes and anaerobes in genital tract
What is difference between postpartum depression and blues?
Blues occurs for <2 wks, mild and self-limited
What factor most increases risk of surgical site infection?
Obesity confers greatest risk
What typically causes dyspareunia in postpartum women?
Atrophic vaginitis - normally + breastfeeding –> lower estrogen levels in vagina
What is the safest method to suppress lactation?
Breast binding, ice packs, analgesics
What Ig is in breast milk?
IgA - decreases newborn’s GI infections
What cancer risk does breastfeeding decrease?
Ovarian cancer
How does breastfeeding affect uterine contraction?
Increases it due to oxytocin release, resulting in decreased blood loss
Which types of contraceptives should be avoided postpartum?
Estrogen-containing, especially in first 30 days, since they increase risk of thromboembolic disease and diminish lactation
What serious infection can happen from postpartum wound or surgical infection?
Staph toxic shock syndrome - Exotoxin binds directly to MHC class II, causing indiscriminate T cell activation and inflammation
Presents with diffuse macular rash and mutiorgan involvement
What antibiotics if toxic shock syndrome is suspected?
Vancomycin
Clindamycin - blocks exotoxin production by blocking ribosome
Zosyn, cefepime, or carbapenem
Iliohypogastric nerve injury can occur in what setting?
C/S via Pfannenstiel skin incision –> decreased sensation or burning pain at suprapubic region
Pudendal nerve injury can occur in what setting?
Prolonged second stage of labor or forceps-assisted delivery
Increased vulvar pain and possible decreased anal sphincter tone (fecal incontinence)
