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Postpartum Complications

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Fever is Principle Sign of Infection ... Immediate=Uterine Atony. Delayed/Late= Subinvolution, Retained placental tissue, Infection ... – PowerPoint PPT presentation

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Title: Postpartum Complications


1
Postpartum Complications
  • By
  • Christine Hicks

2
Complications
  • Infections
  • Genital Tract
  • Perineum Vulva
  • Endometritis
  • Pelvic Cellulitis Peritonitis
  • Incisional
  • C Section
  • Episiotomy

3
  • Infections (continued)
  • Mastitis
  • Urinary Tract Infection
  • Hemorrhage
  • Thrombophlebitis

4
Infection
  • Prevention is the Goal
  • Careful Assessment
  • Practice of Universal Precautions
  • Health Teaching
  • Risk Factors (p. 1029)
  • General Infection Risks
  • Related to Labor Event
  • Related to Operative Procedure

5
  • Fever is Principle Sign of Infection
  • Elevated Temperature of 102.2 F any time or 101.4
    F on 2 successive occasions
  • C Section delivered patient is at higher risk
  • Assessment (Refer to previous lecture)

6
Infections of the Genital Tract
  • Result of bacteria ascending from the genital
    tract
  • Often remain localized
  • Most common organisms
  • Gram positive cocci (Streptococcus)
  • Gram negative bacilli (Bacteroides)

7
Infections of the Perineum Vulva
  • Localized
  • Involves repaired perineal lacerations or
    episiotomy
  • Assess for elevated temperature, pain, sensation
    of heat of the affected area site is red and
    edematous seropurulent discharge

8
  • Treatment
  • Physician removes sutures opens wound
  • Wound must be kept clean
  • Sitz Baths/Heat Lamp
  • Antibiotics/Analgesics
  • Teaching

9
Endometritis
  • Localized infection of inner uterine wall
  • 2-3 of vaginally delivered patients develop
  • Risk factors include prolonged labor ruptured
    membranes
  • Develops 48-72 hours post delivery

10
  • Assessment includes
  • Fever
  • Lower Abdominal Pain
  • Uterine Tenderness
  • Foul-smelling Discharge
  • Tachycardia
  • Leukocytosis

11
  • Treatment
  • IV Antibiotics
  • Fowlers Position
  • Oxytocic Medications
  • Monitors Involution Process (Fundus)
  • Fluids Well-balanced Diet
  • Vital Signs
  • Isolation may be necessary
  • Emotional Support

12
Pelvic Cellulitis Peritonitis
  • Infection that extends along the blood vessels
    lymphatics to the pelvic structures
  • Peritonitis--major life-threatening infection

13
Infection of Incision
  • Types of Incision
  • Episiotomy
  • C-Section

14
Mastitis
  • Acute infection of glandular tissue of the breast
  • Breast-feeding Mothers
  • Staphylococcus aureus
  • Assessmentfissures erosions of the nipples
    pain temperature firmness red
  • Unilateral condition

15
  • Treatment
  • Abscesses will need to be drained
  • Cold Heat Therapy
  • Antibiotics
  • May need to discontinue Breastfeeding
  • Wear firm, supportive bra

16
Urinary Tract Infection
  • Risk
  • Indwelling catheter
  • C-Section
  • Epidural Anesthesia
  • Assessment
  • Burning on urination
  • Urgency
  • Frequency
  • Low-grade fever

17
  • Treatment
  • Urine Specimen
  • Antibiotics, Antispasmodics, Analgesics
  • Nutrition Hydration
  • Rest
  • Repeat Urine Cultures

18
Hemorrhage
  • Leading cause of Maternal Mortality
  • Types
  • ImmediateWithin 24 Hours
  • DelayedAfter 48 Hours
  • LateAfter PP Day 5

19
  • Causes
  • ImmediateUterine Atony
  • Delayed/Late Subinvolution, Retained placental
    tissue, Infection
  • Assessment includes Profuse bleeding from the
    vagina, Boggy uterus, Vasoconstriction, Changes
    in pulse Bp, Changes in orientation, Changes in
    urinary output

20
  • Treatment
  • IV Therapy
  • Oxytocic Medications
  • Oxygen
  • Trendelenburg Position
  • Vital Signs
  • Palpation of Fundus

21
Thrombophlebitis
  • Clot formation attached to the vessel wall
  • Sites include ovarian, uterine, femoral
  • Femoral Assessment includes Pain, Swelling,
    Paleness, Redness, Warmth
  • Prevention of Pulmonary Embolism is the Goal

22
  • Treatment
  • Rest
  • Elevation of the Leg
  • Analgesics Anticoagulants
  • Heat or Cold Therapy
  • Surgical Treatment in some cases
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