OTHER POSTNATAL COMPLICATIONS Flashcards Preview

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Flashcards in OTHER POSTNATAL COMPLICATIONS Deck (25):
1

What is the other term for postnatal infection?

Puerperal pyrexia / infection

2

What is the definition of puerperal pyrexia?

Maternal temperature of 38˚C maintained for 4-6 hours in the first 14 days after delivery

3

What is the most common infection associated with puerperal pyrexia?

Endometritis caused by Group A Streptococcus

4

What is the most common cause of maternal death in the UK?

Sepsis

5

What are the usual sites of infection in postnatal infection?

Uterus
Abdominal incision
Perineum
Chest
UTI
Breast

6

What are the risk factors for developing endometritis?

Caesarian section

Retained products

Manual removal of placenta

7

What are the symptoms of endometritis?

Lower abdominal pain

Foul smelling vaginal discharge

Fever

8

What are the risk factors for postpartum infection of the perineum?

Vaginal tear

Episiotomy

9

What is the antibiotic of choice for postpartum mastitis?

Flucloxacillin

10

Should a woman being treated for postpartum mastitis continue to breast feed?

Yes

11

What antibiotics should be given for endometritis causing puerperal pyrexia?

Clindamycin and gentamicin until afebrile for more than 24 hours

12

What is the incidence of post-natal depression?

Around 10% of women

13

What is the incidence of puerperal psychosis?

0.2%

14

What is the incidence of baby blues?

70% of women

15

What is the normal time frame for the baby blues?

Typically seen 3-7 days postpartum with a peak of 5 days

16

Who is normally affected by baby blues?

Primips

17

What are the features of the baby blues?

Anxiety

Irritable

Tearful

18

What is the time frame for postnatal depression?

Most cases occur within a month and peak at 3 months

19

What are the features of postnatal depression?

Similar to depression in other circumstances:

Anxiety
Low mood
Fatigue
Irritability
Feelings of inadequacy
Ambivalence towards baby
Reduced or absent libido

20

What is the time frame for puerperal psychosis?

Onset is usually in the first 2-3 weeks postpartum

21

What are the features of puerperal psychosis?

Insomnia or early morning wakening
Lability of mood
Overactivity
Disorientation
Lack of insight
Hallucinations
Persecutory beliefs
Recurrent thoughts of death

22

How do we manage the baby blues?

Reassurance

Support

23

How do we manage postnatal depression?

CBT

SSRIs can be used if severe

24

Which SSRIs are recommended in postnatal depression?

Paroxetine (low milk/plasma ratio) or Sertraline

Fluoxetine not recommended because of long half life

25

How do we manage puerperal psychosis?

Normally requires admission to hospital

Lithium not recommended with breast feeding

ECT is safe