Puerperium Flashcards
(18 cards)
What is the main line of treatment in puerperal sepsis?
Stabilizing the patient’s general condition and using broad spectrum antibiotics by IV
Antibiotics may include a combination of Clindamycin, Gentamicin, Piperacillin/Tazobactam, or Carbapenem.
What position is recommended to promote drainage in puerperal sepsis treatment?
Fowler’s position
This position helps facilitate drainage and improve respiratory function.
List two complications associated with puerperal sepsis.
- Breast engorgement
- Urinary tract infection (pyelitis or cystitis)
Other complications may include respiratory infections, meningitis, and deep venous thrombosis.
At what weeks of gestation is amniocentesis typically performed?
14-16 weeks of gestation
This timing is crucial for assessing lung maturity and conducting other diagnostics.
What is the L/S ratio used for in amniocentesis?
Assessing lung maturity
The L/S ratio helps determine the readiness of the fetal lungs for breathing after birth.
What are the therapeutic values of amniocentesis?
- Amnioreduction
- Amnioinfusion
- Induction of abortion
- IU transfusion
These procedures can address various fetal conditions and complications.
What are some complications of amniocentesis?
- Rupture of membranes
- Fetal infection
- Placental abruption
- FMH
- Alloimmunization
Complications can have serious implications for both the mother and fetus.
When is chorionic villous sampling (CVS) performed?
From 7-12 weeks (TV) and after 12 weeks gestation (TA)
CVS is used for early genetic testing.
When should cordocentesis be performed during pregnancy?
After 18 weeks gestation
This procedure is used for obtaining fetal blood for testing.
How is Down syndrome screened in the first trimester?
- US evaluation of nuchal translucency (NT)
- Double marker test: high hCG, low PAPP-A levels
A high-risk score may lead to further testing such as a triple marker test, CVS, or amniocentesis.
What is the purpose of the second trimester US fetal anatomy survey?
To screen down S in the second trimester
It helps in assessing fetal development and identifying potential anomalies.
What are the results of the triple marker test indicating high risk?
High hCG levels with low MSAFP and uE3 levels
A high-risk score may prompt further testing such as amniocentesis or CVS.
List indications for amniotomy
- Post term pregnancy
- IUFD
- CFMF incompatible with life
- IUGR
- Rh isoimmunization
- Severe polyhydramnios
- Chorioamnionitis
- APH not suitable for conservative treatment
- Medical indications: DM, Hypertensive disorders of pregnancy
Amniotomy is performed for various maternal and fetal conditions.
List contraindications for amniotomy
- CPD or malpresentation
- Pelvic tumor with pregnancy
- GMP for fear of uterine rupture
- Previous uterine scar
- Cardiac disease
- Fetal distress
- When CS is indicated
Contraindications ensure the safety of both mother and fetus.
What are some complications of amniotomy?
- Placental separation (abruption)
- Vaginal bleeding
- Prolapse of the cord
- Infection
Complications can arise during or after the procedure.
What are the types of drugs classified as ecbolic?
- Oxytocin
- Prostaglandins
- Ergot Alkaloid
Ecbolic drugs are used to induce labor or enhance uterine contractions.
What are the types of pain associated with a vesicular mole?
- Dull aching pain - rapid uterine distension
- Colicky pain - uterine contractions
- Severe sharp pain - uterine perforation, concealed hemorrhage, complicated theca lutein cyst of the ovary
Understanding pain types helps in diagnosing complications.
What are the causes of vomiting in pregnancy?
- Emesis & HEG
- Gestational thyrotoxicosis
- Any cause of increased ICT (e.g. brain tumors)
- Mismatched blood transfusion
- V.M
- Multifetal pregnancy
- Acute polyhydramnios
- GIT disorders (e.g. peptic ulcers, appendicitis)
- Preeclampsia & HELLP
- Infective hepatitis
- Cholecystitis
- Drug poisoning
- Acute fatty liver of pregnancy
- Intrahepatic cholestasis of pregnancy
These causes can range from benign to serious and require careful evaluation.
