Physiology of the Puerperium Flashcards Preview

YEAR 3 REVISION > Physiology of the Puerperium > Flashcards

Flashcards in Physiology of the Puerperium Deck (32)
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1
Q

What 3 things aid the involution of the uterus?

A
  1. Contractions
  2. Autolysis
  3. Epithelial regeneration and proliferation
2
Q

What is ischaemia?

A

Tissue death caused by the constriction of uterine blood vessels following delivery

3
Q

What is autolysis?

A

The use of proteolytic enzymes to ingest redundant ischaemic muscle fibres

4
Q

What are the 3 types of lochia?

A
  1. Lochia Rubra
  2. Lochia Serosa
  3. Lochia Alba
5
Q

Describe lochia rubra

A
  • Red in colour
  • Fresh blood from placental site
  • Lasts 3-4 days
6
Q

Who may experience less lochia?

A

Women who had a CS

7
Q

Describe lochia serosa

A
  • Pink in colour
  • Lasts 10-14 days
  • May have slightly sweet odour
8
Q

Describe lochia alba

A
  • Cream/white in colour

- Lasts 4-8 weeks

9
Q

What may happen around day 7?

A

A fresh loss of red blood due to the fibrin mesh being shed from the placental site

10
Q

What hormonal changes occur following delivery?

A
  • Decreased oestrogen and progesterone
  • Increased prolactin and oxytocin
  • FSH and LH will eventually increase to recommence ovulation
11
Q

What is lactational amennorhoea?

A

The absence of a period due to breastfeeding - this does not mean they cannot get pregnant

12
Q

Why is urinary output decreased in the first 48 hours?

A
  • Decreased oestrogen levels reduces the plasma volume of the blood so less water is absorbed
  • Decreased progesterone levels causes unbalanced aldosterone levels
13
Q

What should be done postnatally to check for urine retention?

A

Women must give a sample of at least 250ml of urine within 6 hours of delivery

14
Q

What should be done if not enough urine is produced after 6 hours?

A
  • Ask them to drink lots of water and try again when desperate
  • If still not enough, bladder scan +/- catheterise
15
Q

Describe the levels of separated recti muscles

A
1cm = normal
2cm = no abdominal exercise for up to 12 weeks
3cm = refer to physio
16
Q

What are the 5 conditions that should be explained to the mother before discharge?

A
  1. DVT
  2. Infection
  3. Preeclampsia
  4. PPH
  5. Mastitis
17
Q

What should all women be advised to take postnatally?

A

10mcg vitamin D

18
Q

What is stress incontinence?

A

Urine leaking when sneezing/coughing/laughing

19
Q

What is urge incontinence?

A

Frequent and sudden urges to pass urine

20
Q

When should a paediatrician do a baby’s NIPE?

A
  • APGARs <6
  • Premature
  • Suspected abnormality
21
Q

How long do women have to pass urine after delivery/ removal of catheter?

A

6 hours to pass 250ml

22
Q

What must all red safeguarding cases have postnatally?

A

Discharge planning meeting

23
Q

When should the postnatal Anti-D injection be given if baby is Rh+?

A

Within 72 hours

24
Q

When should ferinject be given?

A

Hb <90

25
Q

When should SATS be performed?

A

6 hours after birth

26
Q

When should the NIPE be performed?

A

Within 72 hours

27
Q

How should DVT be explained to the mother?

A
  • Unusual lumps in 1 leg (or both)
  • Pain/ redness/ swelling (unilateral usually)
  • Chest pain = call 999
28
Q

How should PET be explained to the mother?

A
  • Headaches and/or visual disturbances
  • Epigastric pain
  • Swelling in hands/feet
29
Q

How should PPH be explained to the mother?

A
  • Soaking pads every hour
  • Clots bigger than a 50p piece
  • Large increase in bleeding
30
Q

How should infection be explained to the mother?

A
  • Pain/ redness/ swelling
  • Feeling unwell
  • Yellow/green discharge
  • Unpleasant smell
31
Q

How should mastitis be explained to the mother?

A
  • Pain/ red patches/ swelling
  • Feeling unwell
  • Pain when feeding
  • Breasts hard/ shiny
32
Q

Why do some babies have swollen nipples?

A

Mother’s circulating hormones