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parent/child: ch 21

QuestionAnswer
Postpartum hemorrhage (PPH) An obstetric emergency & the leading cause of maternal mortality throughout the world; defined as a blood loss of 500mL or more of blood after a vaginal birth & 1000mL or more after a c-section
Uterine atony If inadequate uterine contraction occurs, the uterus remains flaccid, & rapid blood loss can follow; leading cause of early PPH
Placenta accreta syndrome PPH can also be due to an abnormally implanted, invasive, or adhered placenta. Treatment: blood components or hysterectomy
Placenta accreta Slight penetration of myometrium
Placenta increta Deep penetration of myometrium
Placenta percreta Perforation of myometrium & uterine serosa, possibly involving adjacent organs
Lacerations Lacerations of the cervix, vagina, & perineum also are causes of PPH; nonlochia bleeding
Hematomas A collection of blood in the connective tissue; vulvar hematomas are the most common type & often occur in association with forceps-assisted birth, an episiotomy, or primigravidity; generally surgically evacuated
Inversion of the uterus Occurs when the fundus collapses into the uterine cavity (turning inside out) after birth; interventions: maternal fluid resuscitation, replacement of the uterus within the pelvic cavity, & correction of associated clinical conditions
Subinvolution of the uterus Delayed return of the enlarged uterus to nonpregnant size & function; causes: retained placental fragments & pelvic infection
Oxytocin (Pitocin) Continuous IV infusion; primary intervention
Misoprostol (Cytotec) Used if oxytocin isn’t working to produce contractions; can be given rectally, sublingually, or orally
Methylergonovine (Methergine) IM; used to produce uterine contractions; *contraindication: hypertension
Dinoprostone (Prostin) Can be given vaginally or rectally for PPH
Methylprostaglandin (Carboprost/Hemabate) IM; *contraindication: asthma
Hemorrhagic (hypovolemic) shock An emergency in which the perfusion of body organs can become severely compromised & death can occur; *late sign: decreasing BP
Postpartum infection Any clinical infection of the genital tract that occurs within 28 days after miscarriage, induced abortion, or birth; presence of a fever of 100.4 or more on 2 successive days of the first 10 postpartum days (not including the first 24 hours after birth)
Mastitis Breast infection; should be considered as possible diagnosis among breastfeeding mothers, with symptoms such as fever, malaise, flulike symptoms, & a sore area on a breast
Endometritis Most common puerperal infection; infection of the lining of the uterus that usually begins as a localized infection at the placental site but can spread to the entire endometrium; treatment: antibiotics
Wound infections REEDA (redness, edema, echomosis, drainage, approximation)
Urinary tract infections (UTIs) Common; risk factors: urinary catheter, frequent pelvic exams, regional anesthesia, genital tract injury, history of UTI, & c-section
Baby blues & postpartum depression Meds: SSRIs & SNRIs are OK for moms to take
Measuring saturated pad Empty pad - full pad = amount of blood
Created by: tatianalopez03
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