Postpartum Hemorrhage, Endometritis, Mastitis, Mental Health Concerns - Maternity | @LevelUpRN
Level Up RN・2 minutes read
Postpartum complications such as hemorrhage, endometritis, mastitis, baby blues, PPD, and postpartum psychosis require specific treatments and care strategies to ensure the well-being of both the parent and the infant. Routine screening for conditions like PPD and postpartum psychosis is crucial for early detection and intervention to support the mental health of parents.
Insights
- Postpartum hemorrhage has different definitions and blood loss thresholds for vaginal and C-section deliveries, with various risk factors such as uterine atony, retained placental fragments, and fetal macrosomia.
- Endometritis, an infection of the endometrium, is associated with vaginal or C-section deliveries, while mastitis, an infection of the breast, is common in breastfeeding patients. Postpartum depression (PPD) can persist beyond two weeks postpartum and requires screening with the Edinburgh Depression Scale for early detection and intervention.
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Recent questions
What are the risk factors for postpartum hemorrhage?
Risk factors for postpartum hemorrhage include uterine atony, birth canal trauma, precipitous delivery, retained placental fragments, coagulopathies, multiparity, multiple births, and fetal macrosomia.
What are the signs and symptoms of endometritis?
Signs and symptoms of endometritis include fever, suprapubic pain, malodorous lochia, tachycardia, and hypotension.
How is mastitis treated?
Treatment for mastitis includes antibiotics, analgesics, patient teaching on prevention methods like good hand hygiene, proper latch, feeding from both breasts, applying heat prior to breastfeeding, and ensuring complete breast emptying.
What are the symptoms of postpartum depression?
Postpartum depression (PPD) can occur within a year of delivery, lasting longer than two weeks, and may involve persistent sadness, mood swings, anxiety, and other symptoms. Screening with the Edinburgh Depression Scale is crucial.
What is postpartum psychosis?
Postpartum psychosis is a severe condition that can arise within two weeks of delivery, posing a safety risk to both the parent and the infant. Symptoms include hallucinations, delusions, confusion, and paranoia, requiring immediate intervention with antipsychotics and other treatments.
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Summary
00:00
Postpartum Complications: Hemorrhage, Endometritis, Mastitis, Treatment
- Postpartum hemorrhage is defined differently for vaginal and C-section deliveries, with specific blood loss thresholds.
- Risk factors for postpartum hemorrhage include uterine atony, birth canal trauma, precipitous delivery, retained placental fragments, coagulopathies, multiparity, multiple births, and fetal macrosomia.
- Signs and symptoms of postpartum hemorrhage include saturating a pad in 15 minutes, soft or boggy fundus, passing large blood clots, constant blood flow from the vagina, and signs of hypovolemic shock.
- Treatment for postpartum hemorrhage involves uterine stimulants like oxytocin, methylergonovine, misoprostol, and carboprost, bimanual compression, uterine packing, and surgical intervention if necessary.
- Nursing care for postpartum hemorrhage includes massaging the fundus, administering oxygen, IV fluids, blood products, and elevating the patient's legs.
- Endometritis is an infection or inflammation of the endometrium, with risk factors including vaginal or C-section delivery, chorioamnionitis, retained placental fragments, premature rupture of membranes, prolonged labor, and internal fetal monitoring.
- Signs and symptoms of endometritis include fever, suprapubic pain, malodorous lochia, tachycardia, and hypotension.
- Treatment for endometritis involves IV or oral antibiotics, hospitalization if necessary, and analgesics.
- Mastitis is an infection and inflammation of the breast common in breastfeeding patients, with risk factors including infrequent feeding, clogged milk ducts, nipple damage, and poor hand hygiene.
- Signs and symptoms of mastitis include flu-like symptoms, unilateral pain, swelling, and erythema of the breast.
- Treatment for mastitis includes antibiotics, analgesics, patient teaching on prevention methods like good hand hygiene, proper latch, feeding from both breasts, applying heat prior to breastfeeding, and ensuring complete breast emptying.
13:12
Postpartum Mood Disorders: Screening and Treatment
- Baby blues are common within the first two weeks postpartum, characterized by dramatic mood swings and typically resolve on their own.
- Postpartum depression (PPD) can occur within a year of delivery, lasting longer than two weeks, and may involve persistent sadness, mood swings, anxiety, and other symptoms. Screening with the Edinburgh Depression Scale is crucial.
- Postpartum psychosis is a severe condition that can arise within two weeks of delivery, posing a safety risk to both the parent and the infant. Symptoms include hallucinations, delusions, confusion, and paranoia, requiring immediate intervention with antipsychotics and other treatments.
- Routine screening for postpartum depression is essential, emphasizing that seeking help is not a sign of weakness or judgment but a way to support the well-being of both the parent and the infant.
- Patients experiencing postpartum hemorrhage may receive oxytocin as a treatment, while those with mastitis may be treated with antibiotics and anti-inflammatory medications. Endometritis is more common in patients who had a C-section. Symptoms of sadness and mood swings lasting beyond two weeks postpartum should be considered abnormal.
