Postpartum Complications Flashcards
(22 cards)
What is Uterine Inversion?
Obstetrical emergency: fundus collapses into the endometrial cavity and turns inside out
What is uterine inversion often related to?
Excessive umbilical cord traction and fundal pressure during stage 3 of labor
What are common risk factors for Uterine Inversion?
macrosmia
Rapid labor and delivery
Short umbilical cord
Uterine abnormalities
Placenta accreta
What are symptoms of Uterine inversion?
Vaginal bleeding
lower abdominal pain
smooth round mass protruding from the cervix of vagina
How do you treat uterine inversion?
Return the uterus back to its correct position
-Stop all uterotonic drugs: help relax uterus
-manually reposition uterus
What uterine relaxing agents can be given to try and treat uterine inversion?
Nitroglycerine, Terbutaline or Magnesium Sulfate
What is Lactational Mastitis?
Inflammation of the breast with fever, myalgia, pain and erythema: either infectious of noninfectious
How do you treat Lactational mastitis?
Dicloxacillin or Cephalexin
Anti-inflammatory meds
Cold compresses
continue breastfeeding
What is postpartum blues and depression?
starts 2-3 days after delivery and resolves in 2 weeks: Blues
What are common symptoms of Postpartum blues?
Sadness, tearfulness, anxiety, insomnia and decreased concentration
What are risk factors for postpartum blues?
Fam Hx of depression
Depression symptoms during pregnancy
Hx of PMS/PMDD
Stress surrounding child care
How do you treat postpartum blues?
no treatment needed
What are risk factors for postpartum depression?
Depression in past
Hx of abuse
young age
unplanned pregnancy
stressful live events
no parter or partner violence
gestational diabetes
not breastfeeding
Miscarriage/stillbirth
What are symptoms of postpartum depression?
Anxiety and panic attacks
irritability and anger
Feeling inadequate or overwhelmed with taking care of baby
Feelings of failure as mother
Fear of hurting self of baby
What is postpartum hemorrhage?
Blood loss >1,000 mL or bleeding with s/s of hypovolemia within 24 hours of delivery
Early: within 24hr
Late: 24 hours to 12 weeks later
What causes postpartum hemorrhage in uterine atony?
Uterine contractions do not compress the blood vessels to stop blood loss
What are other common causes of postpartum hemorrhage?
Laceration
retained parts
coagulopathy
What are common risk factors for postpartum hemorrhge?
Anesthesia
Uterine overdistension: twins and polyhydramnios
Prolonged Labor
Retained placenta: placenta accreta
Coagulopathy
How does Sheehan syndrome present?
after postpartum hemorrhage: inability to breastfeed +/- Panhypopituitarism
How does treatment for Postpartum hemorrhage begin?
Bimanual examination: assure no rupture and no retained placenta
After bimanual exam what can be done for postpartum hemorrhage?
Bimanual compression and massage
If bimanual compression and massage fail to stop postpartum hemorrhage what can be used?
OT: help uterus contract and constrict vessels
Methylergonovine
Carboprost
Misoprostol
