Puerperial Pyrexia Flashcards
(11 cards)
What are the aseptic precautions for postpartum prophylaxis?
Postpartum prophylaxis includes aseptic precautions for at least 1 week following delivery until the open wounds in the uterus, perineum, and vagina are healed.
This helps prevent serious infections.
What are the indications for laparotomy and hysterectomy in postpartum complications?
Laparotomy is indicated in cases of non-responsive peritonitis,
rupture or perforation, multiple abscesses, gangrenous uterus, or gas gangrene infection.
Ruptured tubo-ovarian abscess should be removed.
What is necrotizing fasciitis and its risk factors?
Necrotizing fasciitis is a rare but fatal complication of wound infection involving muscle and fascia, with risk factors including diabetes, obesity, and hypertension.
Infection is often caused by Group A beta-hemolytic Streptococcus.
What is the treatment for necrotizing fasciitis?
Treatment includes rehydration, wound scrubbing, debridement of all necrotic tissues, and use of high-dose broad-spectrum IV antibiotics.
What are the indications for intensive care unit management?
Indications include hypotension, oliguria, raised serum creatinine, raised serum lactate, thrombocytopenia, ARDS, and hypothermia.
What is the general care for patients with bacteremic or septic shock?
General care includes isolation, adequate fluid and calorie maintenance via IV, correction of anemia, use of an indwelling catheter, and maintaining a chart of vital signs and fluid intake/output.
What is the empirical antibiotic therapy for suspected infections?
Empirical therapy includes gentamicin, clindamycin, and metronidazole until culture and sensitivity reports are available.
Treatment should continue for at least 7-10 days.
What is the choice of antibiotic regimens for severe sepsis?
A combination of piperacillin-tazobactam or carbapenem plus clindamycin provides the broadest range of antimicrobial coverage.
What are the steps in perineal wound management for episiotomy wound infection?
Management includes IV antibiotics, removal of sutures and wound dressing, wound debridement, repeated sitz baths, and secondary wound repair with nonabsorbable suture.
What should be done for retained uterine products?
Retained uterine products with a diameter of 3 cm or less may be disregarded; otherwise, surgical evacuation after 24 hours of antibiotic coverage is recommended to avoid septicemia.
How are cases of septic pelvic thrombophlebitis treated?
Cases are treated with IV heparin for 7-10 days.
