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PUERPERAL COMPLICATIONS Part 02

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POSTPARTUM PYREXIA

Definition

any fever of > 38.0 ?C on any 2 of the first 10 days postpartum, except the first day

Causes

  1. Wind

    • atelectasis (especially after general anesthesia)
    • pneumonia

  2. Water (UTI)
  3. Wound (gram +/-  aerobes, and anaerobes)

    1. C-section incision site
    2. episiotomy site
    3. empiric treatment: clindamycin + gentamicin
    4. prophylaxis against post-C/S endometritis

      • begin antibiotic immediately after cord clamping  and administer only 1-3 doses
      • cefazolin is most common

  4. Walking

    1. pelvic thrombophlebitis (diagnosis of exclusion)
    2. DVT

  5. Breast

    1. engorgement may cause slight physiologic temperature rise on first day
    2. mastitis (Staphylococcus aureusmost common)

  6. Endometritis : blood and genital cultures

POSTPARTUM MOOD ALTERATIONS

Postpartum blues

  1. very common, 85% of new mothers
  2. onset day 3-10
  3. considered an extension of the “normal” hormonal changes and adjustment to a new baby
  4. self-limited, does not last more than 2 weeks
Postpartum depression
  1. signs and symptoms of major depression occurring in a woman within 6 months of childbirth
  2. incidence of 10-20%suspect if the ìbluesî last beyond 2 weeks, or if the symptoms inthe first two weeks are severe (e.g. extreme disinterest in the baby, suicidal or homicidal ideation)
  3. treatment with antidepressants is often necessary
  4. interferes with bonding and attachment between mother and baby so it can have long term effects
Postpartum psychosis
  1. rare (0.2%)
  2. presents as an acute psychotic episode, or can occur in the context of a depression

PUERPERAL COMPLICATIONS Part 02 PUERPERAL COMPLICATIONS Part 02 Reviewed by Radiology Madeeasy on September 08, 2010 Rating: 5
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