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POSTNATAL CARE (Early postnatal checks: (Examination (obs - signs of…
POSTNATAL CARE
Early postnatal checks:
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Examination
obs - signs of anaemia, sepsis, haemorrhage
abdo exam - 1st day of birth = palpable uterine fundus at umbilicus - reduces and no longer palpable by 10-14th day
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postnatal problems
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Bowel problems
constipation
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oral meds- irone, codeine, narcotic analgesia received in labour
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breast problems
if not breastfeeding, suppression of lactation is often a problem with engorgement => discomfort
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incontinence
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neuropraxia - impaired pudendal nerve - compression - commonly resolves spontaneously - if not then need PT or gynaecologist
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puerperal pyrexia
38C on any occassion in first 14 days
pyrexia usually due to urinary or genital infections (including endometritis) - may be related to chest or breast infection
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mid stream specimen of urine, endocervical and wound swabs sent for analysis
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RF for puerperial sepsis = maternal obesity, caesarean section, carriage of Group A Streptococcus
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venous thromboembolism
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RF - high BMI, post C-Section
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Encourage early mobilisation, avoid dehydration
sign of DVT - swelling, redness, pain in leg/calf, may be asymptomatic
PE accompanied by dyspnoea, chest pain, Cardioresp collapse - prompt diag and treat with LMWH
superficial thrombophlebitis - painful, eryhtematous and tender vein - treat w/ support stockings and antiinflammatory drugs
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Late postnatal checks:
around 6 wks after brith - review birth address any qs, assess baby and how mum is coping - any tiredness/depression
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discuss contraception, enquore whether intercourse has resumed