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26 Cards in this Set
- Front
- Back
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post partum hemmorhage
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leading cause of maternal morbidity
often few s/s >500 mL blood loss vaginal birth/1000 mL c-birth OR 10% change in Hct |
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types of PPH
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primary - within 24 hours
secondary 24 hours to 6 weeks |
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uterine atony
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hypotonia of uterus - leading cause of PPH
causes - distended bladder, large baby, anethesia, polyhydramnios |
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lacerations of genital tract
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can cause PPH
if lbeeding continues w/ firm/contracted uterus - varying amount of bleeding |
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retained placenta
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1) nonadherant (manual removal)
2) adherant (in myometrium) placenta acreta - slight increta - deep percreta - perforation |
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inversion of uterus
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partial or complete
r/t multiparity & placenta accreta/increta may need hysterectomy severe pph, shock, pain |
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subinvolution of uterus
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does not return to normal size - large boggy uterus
late pp bleeding r/t retained placenta fragments/pelvic infection |
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managing PPH
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frequently assess
correct cause |
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medications for PPH
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ocytocin
ergotrates protagladim IV fluids blood/blood components |
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oxytocin
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contraction of uterus
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merthergine
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contraction of uterus
side effects = hypertension, n/v, headache c/i - hypertension, cardiac disease |
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prostaglandin (Prostin)
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contraction of uterus
side effects - headache, N/V, fever, tachycardia, hypertension |
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labs indicating coagulopathies
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increased prothrombin time, increased partial thromboplastin time, decreased platelets, decreased fibrinogen, increased fibrin degredation, prolonged bleeding time
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idiopathic thrombocytopenic purpura
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autoimmune disorder - antiplatelets destroy platelets
treat with corticosteroids/IV immunoglobin can cause neonatal thrombocytopenia |
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von Willebrand disease
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factor VIII deficiency & platelet dysfunction
factor VIII normally increased in pregnancy treat: give factor VII, desmopressin/antifibrolytics |
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DIC
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clotting factors consumed
widespread bleeding and clot formation correct underlying cause, volume replacement, blood component therapy, O2 |
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pp psychosis
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depression, delusions, thoughts of harming infant or self'
primiparas associated with bipolar disorder |
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pp depression
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10-15% of new mothers
fatigue is predictor intense, mood swings - irritability = distinguishing factor |
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PP baby blues
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let down - usually mild
begins 2-3 days after birth, disappears within a week or 2 peaks 5-10 days |
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mastitis
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2-10% of women, 2-4 weeks pp
usually caused by staph - starts with nipple fissure, may progress to abscess flu like s/s, breast tenderness, redness, swelling antibiotics - keep feeding |
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endometritis
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s/s uterine tenderness, backache, N/V, foul lochia, fever, chills, increased pulse, lethargy
begins at placenta site group b strep |
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postpartum infections
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occur within 28 days of miscarriage, abortion, or childbirth
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causes of postpartum thromboembolic disease
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venous stasis
hypercoagulation |
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superficial vein thrombosis
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most frequent
pain and tenderness in lower extremity warm, redness, enlarged, hardened vein NSAIDs, rest/elevate leg, elastic stockings, heat |
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deep vein thrombosis
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unilateral leg pain
calf tenderness swelling postive homans sign anticoagulants (heparin, then coumadin 3 months), rest and elevate, analgesics |
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pulmonary embolus
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dyspnea and tachypnea
heparin, then coumadin for 6 months analgesics |
