ABNORMAL PUERPERIUM

 BLEEDING - SECONDARY PPH  INJURY – TEARS, HEMATOMA  INVERSION  INFECTION  PSYCHIATRIC PROBLEMS

POST PARTUM HEMORRHAGE  1% - (5-10) DAYS  RETAINED PRODUCTS,INJURY,INFECTIONS, INVERSION,TROPHOBLASTIC DISEASE, FORIEGN BODIES,COAGULATION DISORDERS  CLINICAL FEATURES – INVESTIGATIONS  TT-OXYTOCICS,ANTIBIOTICS, TRANSFUSION

INJURY- TEARS,HEMATOMA  LACERATIONS  DIFFICULT LABOUR, MANIPULATION,INSTRUMENTS  EXAMINATION-PPH WITH CONTRACTED UTERUS  CX,VAGINA,PERIURETHRAL,PERICLITORAL, PERINEUM,COLPORRHEXIS,LOWERSEGMENT  HEMATOMA  VULVAL,PARAVAGINAL,SUPRAVAGINAL  TT-SEDATE,ANALGESICS,,I&D,SUTURE,ANTIBIOTICS

INVERSION RARE –SERIOUS INCOMPLETE / COMPLETE, DEGREES- 1 ST,2 ND,3 RD PLACENTAL -CREDES, MRP.CORD-SHORT,LOOPS. FUNDAL FIBROID CLIN - DIMPLE,POLYPOIDAL SHAGGY ASS,PALLOR,SHOCK TT-REST,SEDATE,SHOCK,REPOSIT WITH TOCOLYTICS,THEN OXYTOCICS, O’SULLIVANS HYDROSTATIC METHOD,HAULTAINS,HYSTERECTOMY

INFECTION CHILDBED FEVER, PUERPERAL SEPSIS 30% MATERNAL MORTALITY 1-8% NORMAL DELIVERIES,MORE IN CS GENITAL TRACT / EXTRAGENITAL PUERPERAL PYREXIA C / F- 2 SEPARATE OCCASIONS,24 HRS APART EXCLUDING FIRST 24 HRS

GENITAL TRACT INFECTION  PRECIPITATING FACTORS – LOCHIA,TRAUMA,,DEVITALISATION,SUTURE,NUTRITION,ANEMIA, PROLONGED LABOUR,P/V EXAMS,PROM,MRP, INSTRUMENT, MANIPULATIONS.  COMMENSALS - AEROBIC AND UNAEROBIC  ENDOMETRIOSIS, MYOMETRIOSIS,PARAMETRIOSIS, SALPINGOOPHERITIS,PELVIC ABCESS,,PELVIC THROMBOPHLEBITIS, PERITONITIS,BACTEREMIA, SEPTICIMIA,ENDOTOXIC SHOCK-DEATH

EXTRAGENITAL INFECTION URINARY TRACT -CYSTITIS,PYELONEPHRITIS RESPIRATORY TRACT - GA VENOUS –LEGS,INFUSION SITE BREAST - MASTITIS,ABCESS GENERAL -INFUENZA,MALARIA

PSYCHIATRIC PROBLEMS 30-50% IRRITABLE,TIRED,ANXIETY,CRYING SPELLS, METABOLIC,HORMONAL REST,REASSURANCE,FAMILY SUPPORT SHORT TERM TRANQUILISER,SEDATIVES PSYCHOSIS - CONFUSION,DELUSION,HALLUCINATION,MANIA,SU ICIDAL,HOMICIDAL TENDENCIES PSYCHIATRIST,MEDICATIONS PERINATAL LOSS- COPING

MISCELLANEOUS  NEUROLOGICAL  LUMBOSACRAL PLEXUS,LUMBOSACRAL DISC FOOT DROP- LAT POPLITEAL  CARDIOMYOPATHY 1IN 5000 CCF,ARRYTHMIA,CARDIOMEGALY VIRAL,IMMUNOGENIC,TOXIC,GENETIC BEDREST,DIG,DIURETICS,OXYGEN 60% -NORMALISE IF NOT DIAGNOSED AND TREATED-DEATH