Post natal care & complaints during post natal period

Slides:



Advertisements
Similar presentations
1 prgilbert/mc-99 REPRODUCTIVE HEALTH: M OTHER- B ABY P ACKAGE.
Advertisements

SALAH M.OSMAN CLINICAL MD. * It is an excessive blood loss from the genital tract after delivery of the foetus exceeding 500 ml or affecting the general.
MATERNAL HEALTH Some technical aspects ANC, Delivery Care and PNC
NORMAL PUERPERIUM.
Postpartum Hemorrhage (PPH) and abnormalities of the Third Stage Sept 12 – Dr. Z. Malewski.
The Postpartal Family at Risk. Assessment of Postpartum Hemorrhage Fundal height and tone Vaginal bleeding Signs of hypovolemic shock Development of coagulation.
Caring for the Woman Experiencing Complications During the Postpartal Period Chapter 16.
Puerperal fever IG: Sio Cheong Un IG: Sio Cheong Un 2011/4/4 2011/4/4.
FEVER AFTER LABOR Dianne MP Graham, MD, CCFP Kelowna, BC, Canada Based on WHO Document on Managing Complications In Pregnancy, 2000.
Postpartum complications II
REPRODUCTIVE HEALTH ISSUES IN PAKISTAN
Abnormal Puerperiu and Postnatal Care
Mother Child Health MCH.
Puerperium Dr. Yasir Katib MBBS, FRCSC Perinatologest.
Puerperal sepsis/infections By F.W. Nkhota-kota.
Endomatritits Al-Najah univercity Nursing college Prepared by :
 Not being able to get pregnant  Common causes for females:  Fallopian tube blockage  Ovulation disorders  Polycystic ovary syndrome  endometriosis.
Abnormal puerperium.
Introduction to Women’s Health Care. What in the world is a women’s health exam? Why would anyone have one? Do I need one?
With one woman dying during pregnancy or complications of childbirth every minute of every day, and 3.6 million neonatal deaths per year, maternal and.
HEAL 6024 The Puerperium.
Nursing Care of Women with Complications After Birth
IN THE NAME OF ALLAH, THE MOST BENEFICENT, THE MOST MERCIFUL.
Chapter 4 Female Sexual Anatomy and Physiology
Problems of the Puerperium Max Brinsmead MB BS PhD May 2015.
Primary Health Care Nursing (NUR 473)
By J. MTENGEZO VICTORIA HOTEL 17 TH JUNE, OUTLINE MDGs - MNH Core Competencies- MNH Content outline Learning guides and checklists Exercises.
MCH Indicators.
Concepts of Maternity Nursing By Dr. Aida Abd El-Razek.
Normal puerperium & lactation The puerperium is the time following labour during which the pelvic organs return to their non pregnant state, the metabolic.
Postpartum Care. TOPICS Routine care of the postpartum woman Routine care of the postpartum woman Common Problems in the postpartum period Common Problems.
MCH Mother and Child Health CHP310: Community Health Program-l Mohamed M. B. Alnoor.
SOCIAL OBSTETRICS Defined as the study of the interplay of social and environmental factors and human reproduction going back to preconceptional.
Induced abortion. -named pregnancy termination. -named pregnancy termination. -two doctor at least should decide induced abortion when these are greater.
NORMAL & ABNORMAL PUERPERIUM Undergraduate Teaching Programme Dr G Holding ST3 02/09/2015.
DIC PUERPERRAL SEPSIS. Puerperal sepsis Bacterial infection of genital tract after delivery. Organism :polymicrobial Mode of infection: Exogenous: external.
When labour is established the uterine contractions will come at intervals (from one hour or more to ten minutes).  The mother should choose a position.
PUERPERIUM & PUERPERAL SEPSIS DR. IQBAL TURKISTANI Asst. Prof. & Consultant Ob/Gyn Dept.
Presumptive indications : Amenorrhea Nausea and vomiting Fatigue Urinary frequency Breast and skin changes Cervical color changes Quickening Probable.
Postpartum endometritis Dr.F Mardanian MD
Normal and Abnormal Puerperium
MATERNAL AND INFANT HEALTH CARE IN PRIMARY HEALTH CARE SETTING Lecture Clinical Application for Community Health Nursing (NUR 417)
NORMAL PUERPERIUM Dr. Madhavi Karki.
Infection International Infection. International Objectives definition predisposing factors pathophysiology clinical features sites of postpartum infection.
Julia Faller, D.O., PGY1 Internal Medicine Lecture Series May 3, 2006
During the puerperium, the pelvic organs return to the non-gravid state, the metabolic changes of pregnancy are reversed and lactation is established.
ROLE OF HOMOEOPATHY IN OBSTETRICS Shyama Kanungo, MD,FICOG,FICMCH Professor O&G, S.C.B.Medical College.
ANTENATAL CARE. Definition  Systematic supervision or care of a woman during pregnancy.  Also called prenatal care.
Natal care(delivery) Aims 1. To insure that every pregnant mother goes through safe delivery. 2- To reduce maternal and fetal loss from birth trauma &
Obstructed Labour & Prolonged Labour.
Chapter 33 Postpartum Complications Mosby items and derived items © 2012, 2007, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.
PUERPERIUM. DEFINITION  It is the period following childbirth during which the body tissues revert back to the pre-pregnant state both anatomically and.
ABNORMAL PUERPERIUM.  BLEEDING - SECONDARY PPH  INJURY – TEARS, HEMATOMA  INVERSION  INFECTION  PSYCHIATRIC PROBLEMS.
P UERPERAL SEPSIS. PUERPERIUM =The time during which: - all the physiological changes of pregnancy is reversed - and the pelvic organs return to their.
POSTPARTUM HAEMORRHAGE
Obstructed Labor & Prolonged Labur.
Unit Eleven Postpartum Complications
Puerperium Dr.F Mardanian MD.
Antenatal & Postnatal Care and How It Is Delivered
Maternal & Perinatal Mortality
Reproductive Health Nursing NUR 324
OPERATIVE VAGINAL DELIVERIES AND CAESAREAN SECTION (C.S)
Mary Jo Bowie MS, BS, AAS, RHIA, RHIT
NORMAL PUERPERIUM.
Chapter 16 Caring for the Woman Experiencing Complications During the Postpartal Period.
POSTNATAL CARE BY MBBSPPT.COM
Post natal care.
NORMAL PUERPERIUM.
DEFINITIONS : QUICK REVIEW
Presentation transcript:

Post natal care & complaints during post natal period Vijay Zutshi MAMC & Lok Nayak Hospital, New Delhi

Normal puerperium and Postnatal Care

Objectives Definition of normal puerperium Various physiological changes during normal puerperium Various aspects of lactation Care of a woman during puerperium Explain the postnatal exercises to be practiced during puerperium.

Definition of Normal Puerperium Child birth – 6 weeks(42 days) First 24 hours Early- up to 7 days Remote- up to 6 weeks

Points to remember for puerperium: Prevention of sepsis at placental site Newborn care Initiation of breast feeding Role of post-natal exercises

Physiological changes in Normal Puerperium Changes in Genital Tract Changes in breast and Lactation Changes in other systems

Changes in Genital Tract Involution of the Uterus Lochia Involution of Other Pelvic Organs Menstruation

Changes in Breast and Lactation Mamogenesis (Mammary duct-gland growth & dev.) Lactogenesis (Initiation Of milk secretion in alveoli) Galactopoiesis (Maintenance of Lactation) Galactokinesis (Removal of Milk from Gland)

Changes in other system Fatigue Pulse slow Temp. subnormal Shivering Fever up to first 24 hours Hb. Rises TLC increases Diuresis- 2nd to 5th day post delivery

Postnatal Care Postnatal Check Up Detection of risk at earlier stage & its management Management of Normal puerperium Treatment of Minor Ailments Treatment of anaemia Health & nutrition education Postnatal Exercise

Postnatal Check Up General health check up Monitoring of involution process For satisfactory establishment of lactation For examination of newborn

Management of Normal Puerperium First hour– important for PPH Early ambulation Avoid strenuous activities for 6 weeks 8-10 hours sleep Needs 300 calories more Care of MLE stitches if any Care of nipples and areola.

Treatment of Minor Ailments After pains Retention of urine Pain at site of perineum Engorgement of breast Treatment of Anaemia

Health & nutrition education Family planning advise Sexual intercourse can be resumed after 6 weeks after delivery Breast feeding is best Immunization of child Calorie need per day-2200+700 =2900 Role of post natal exercises

Postnatal Exercise Pelvic floor exercise Abdominal tightening Pelvic tilting or rocking Rectus gap Hip hitching Foot and Leg Exercise

ABNORMAL PUERPERIUM

OBJECTIVES Importance of puerperal infections to maternal morbidity and mortality Definition of puerperal fever and puerperal sepsis Various puerperal abnormalities Causes of puerperal fever Aseptic and antiseptic measures to be adopted for the prevention of puerperal sepsis Management of the various abnormalities.

Abnormal puerperium Sepsis is the commonest complication during puerperium but largely preventable.

Puerperal Fever/Pyrexia Oral temp. 38 degree C or more recorded twice in the first 10 days after delivery.

Causes of Puerperal fever Uterine infection Breast infection Urinary infection Thrombophlebitis Other incidental infections

Puerperal Sepsis Definition Risk Factors for Puerperal Sepsis Diagnosis Management Complication

Definition Infection of genital tract : Delivery-42 days after delivery Two or > features to be present pelvic pain, fever 38.50 C, vaginal D/S, smell of D/S, sub-involution

Risk Factors for Puerperal Sepsis Anaemia Malnutrition DM Prolonged labor Obstructed labor Prolonged PPROM Frequent vaginal examinations

Contd…. Operative delivery Un-repaired tears PPH Poor hygiene Poor aseptic technique for delivery Manipulations high in the birth canal Retained bits of placenta or membranes Pre-existing STDs

Diagnosis Endometritis Subinvolution Pelvic cellulites Salpingitis & peritonitis Pelvic thrombophlebitis Septicaemia

Management Preventive Good antenatal care Proper intra-natal care Post natal care Curative General care Antibiotics for infection Local care of various wounds

Complication Septicaemia Septic shock DIC Pulmonary embolization Distant spread of infection Kidney failure Death

Contd…. Late complications: Menstrual problems Chronic pelvic pain Chronic PID Secondary infertility

Infections Associated with Childbirth Process other than Puerperal Sepsis Breast Problems Urinary Problems Venous Thrombosis

Breast Problems Retracted / cracked nipples Breast engorgement Mastitis Breast abscess Failure of lactation

Urinary Problems Retention Incontinence Infection

Venous Thrombosis Due to hypercoagulable state of pregnancy Predisposing factors: Increasing maternal age Obesity Anaemia Dehydration Trauma Infection Smoking Reduced mobility

Puerperal Morbidity other than infection Secondary Hemorrhage Puerperal Psychosis Obstetric Palsy

Secondary Hemorrhage Due to: Infection Retained bits of placenta & membranes Subinvolution

Puerperal Psychosis Transient Self limiting Antidepressants & psychological counseling

Obstetric Palsy Severe neuralgia due to pressure on lumbo-sacral nerve plexus Foot drop Rarely femoral, obturator or sciatic nerves may be involved Spontaneous recovery usually Physiotherapy is helpful

Conclusions Importance of history Systematic evaluation Proper advise & motivation regarding contraception Importance of immunization for new born Stress upon post natal exercises.

Thank you