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38 Cards in this Set
- Front
- Back
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-leading cause of maternal morbidity and mortality in the world is:
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Postpartum Hemorrhage,-
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Postpartum Hemorrhage definition:
-vaginal birth -c section |
-defines as he loss of more than 500 ml of blood after vaginal birth
loss of blood --1000 ml after cesarean birth |
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-what 2 other things have also been used to define PPH
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10% change in hematocrit b/w admission for labor and postpartum
or the need for erythrocyte transfusion |
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Postpartum Hemorrhage
-classified as early or late with respect to the birth -early/acute/primary PPH -late/secondary PPH |
-early/acute/primary PPH: occurs within 24 hours of birth
-late/secondary PPH: occurs more than 24 hours but less than 6 weeks postpartum |
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Uterine Atony
-marked ______ of the uterus |
hypotonia
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-if the uterus is flaccid after detachment of all or part of the placenta, brisk venous bleeding occurs and normal coagulation of the open vasculature is impaired and continues until uterine muscle is contracted
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uterint atony
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-uterine atony is the leading cause of _________
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pph
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Uterine Atony
- associated with: (4) •-red headed patients have a tendency to bleed more (T or F) |
-it is associated with
high parity, hydramnios, -lots of fluid. When she was pregnant, there was a lot of amniotic fluid and the uterus got stretched. When the uterus is stretched, it doesn’t crush down as well and it doesn’t slow the bleeding macrosomic fetus - big baby=stretching multifetal gestation TRUE |
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Adherent retained placenta caused PPH
Placenta accreta- |
slight penetration of myometrium by placental trophoblast (just a little growth into the muscle layer, you can scrape it but you can’t get it off because its growing into the uterus)
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Adherent retained placenta caused PPH
Placenta increta |
-deep penetration of myometrium by placenta growing considerably into muscle
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Adherent retained placenta caused PPH
Placenta percreta |
-perforation of uterus by placenta placenta grows through the uterus. Usually a hysterectomy
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– Inversion of uterus (happens when someone does a 1 handed check b/c they are not support the neck of the uterus)
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can cause PPH
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Subinvolution of uterus (not returning to pregnancy, not contracting)
–causes: |
infection and retrained placental fragments
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-postpartum, or puerperal infection is any clinical infection of the genital canal that occurs within
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28 days after miscarriage, induced abortion, or childbirth
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-presence of a fever of 38 degrees C(100.4 F) or more on 2 successive days of the first 10 postpartum days (not counting the first 24 hours after birth)
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-postpartum, or puerperal infection
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-common postpartum infections include
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endometritis
wound infections mastitis, UTIs respiratory tract infections |
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-postpartum, or puerperal infection
-most common infecting organisms are the (2) |
streptococcal and anerobic organisms
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--postpartum, or puerperal infection
incidence is 5-10 times higher (in vaginal births or c-sections) |
after c sections
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-most common postpartum infection
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Endometritis-infection inside the uterus
-incidence is higher after c section |
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Endometritis
s/s |
s/s: fever, greater than 38 degrees Celsius, increase pulse, chills, anorexia, nausea, fatigue, lethargy, pelvic pain, uterine tenderness, foul smelling profuse lochia
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Endometritis
2 lab findings |
-leukocytosis and increase of RBC are lab findings
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Endometritis
treatment: |
-treatment: IV broad spectrum antibiotics (cephalosporins, penicilins, clindaycin, gentamicin)
as well as hydration, rest, pain relief… cool compresses, warm blankets, perineal care, sitz baths |
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Fever, pain, foul-smelling, profuse lochia, pus on pad
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Endometritis
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-common postpartum infections, develop when woman is at home
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wound infections
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-signs: erythema, edema, warmth, tenderness, seropurulent drainage, wound separation, fever and pain
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wound infections
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wound infection
-treatment: |
-treatment: combine antibiotic therapy with wound debridement …sitz baths, warm compresses, perineal care.
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UTI
-risk factors: |
urinary cathertization, frequent pelvic exams, epidural anesthesia, genital tract injury, history of UTI, and cesarean birth
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UTI
s/s |
-s/s: dysuria, frequency and urgency, low grade fever, urinary retention, hematuria, pyuria, costovertebral angle tenderness or flank pain may indicate upper UTI
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UTI
treatment |
-treatment: antibiotic therapy, analgesia, hydration
INCREASE FLUID INTAKE |
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-affects about 1% of woman after childbirthastitis, most of who are 1st mothers who breastfeed
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mastitis
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Mastitis -almost always unilateral and develops when?
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well after the flow of milk has been established
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-organism is hemolytic S. aureus
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mastitis
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-an infection nipple fissure is the initial lesion but the ductal system is involved next
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mastitis
-inflammatory edema and engorgement of the breast soon obstruct the flow of milk in a lobe |
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mastitis -if not treated, can lead to
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breast abscess
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-s/s: chills, fever, malaise, local breast tenderness
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mastitis
-localized breast tenderness, pain, swelling, redness, axillary adenopathy may occur |
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mastitis
-lactation can be manifested by: |
-lactation can be manifested by emptying the breasts every 2-4 hours by breastfeeding, manual expression, breast pump and discarding the milk
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-treatment for mastitis:
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intensive antibiotic therapy (cephalosporin’s and vancomycin which help with staphylococcal infections)
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mastitis, warning sign is:
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warning sign is cracked nipples
-support of breasts -local heat or cold -adequate hydration -analgesics CAN BREAST FEED |
