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