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  1. 1. A woman presents with bloodstained discharge 3 days after her pregnancy. What is this?
    Lochia, which is normal for 14 days
  2. 2. How long after pregnancy does menstruation return?
    usually delayed by lactation, otherwise within 6 weeks.
  3. 3. A woman has had an epidural. What should you check after pregnancy?
    fluid balance should prevent retention.
  4. 4. How is primary postpartum haemorrhage defined?
    loss of more than half a litre of blood in 24 hours after delivery.
  5. 5. What is the major cause of PPH?
    atonic uterus or retained placenta.
  6. 6. what do you give to prevent postpartum haemorrhage and when?
    Oxytocin in the 3rd stage of labour.
  7. 7. What is secondary postpartum haemorrhage?
    excessive blood loss between 24 hours and 6 weeks.
  8. 8. What is the main cause of secondary PPH?
    endometritis and rarely choriocarcinoma.
  9. 9. What are the most important causes of endometritis?
    B haemolytic strep, staph, e. Coli
  10. 10. what is the leading cause of maternal mortality?
    dvt or pe
  11. 11. what are causes of postpartum pyrexia?
    infection (endometritis, uti, chest infection, wound infection, mastitis, perineal infection), DVT (low grade fever)
  12. 12. What psychiatric complications are there of pregnancy?
    postnatal depression, peurperal psychosis
  13. 13. When are hypertensive complications most common?
    pre-eclampsia takes 24 hours to recover after delivery.
  14. 14. A woman presents with severe abdominal pain 24 hours after her pregnancy. She also has stress incontinence. What are you considering?
    urinary retention. Catheterise for 24 hours.
  15. 15. What are 'after pains'?
    Contractions which are normal for 4 days after pregnancy. The internal os should be closed by 3 days.
  16. 16. How common is perineal pain?
    In 40% of women after delivery, for more than 8 weeks in 10 %. Give Voltarol.
  17. 17. How do you identify a paravaginal haematoma?
    severe pain in the perineum a few hours after delivery. Vaginal examination.
  18. 18. A postpartum woman destribes faecal incontinence. What must you exclude and check?
    Exclude rectovaginal fistula. Consider anal sphincter or pudendal nerve damage. Look for tears.
Card Set
obs + gynae
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