Puerperium Complicatoon
Breast engorgement
Occurn 2-4 days post-partum
Partcularly io thlone hhlo areo’t breantfeediog or if it in ioterrupted an thlin leadn to vascular and lymphatc
stasis
Preneotatoo – Heavy, teoder, frm, harm breantn
Rx – Tig hlt fiog bra, Ice packn, Aoalg enicn, Bromocriptoe dopamioe ag ooint hhlichl iohlibitn PRL)
Mastts
Occurn 3-4 weeks post-partum
Reg iooal iofectoo of breant pareochlyma unually Staph aureus)
Uocommoo, but more no io primiparoun homeo
Preneotatoo - fever, chlilln, focal breant erythlema/oedema/teoderoenn clioical diag oonin)
Rx – Cootoue breantfeediog overcomen ductal obntructoo), Aoalg enia, Flucloxacillin PO
Complicatoon – Abncenn 10%)) hhlichl requiren nurg ical draioag e
Endometrits
Polymicrobial infecton of thle eodometrium thlat ofeo alno iovaden myometrium
Seeo afer 5) of vag ioal deliverien, aod afer 25-5%) of C-secton deliverien
Rink factorn – C-nectoo, proloog ed ROM, multple vag ioal examioatoon, maoual placeota removal, ioteroal
foetal mooitoriog
Rx – IV Broad spec Anbx – Cliodamycio aod Geotamycio Stop hhleo afebrile for 24-48hlrn), D&C if
retaioed productn nunpected)
Complicatoon – Eodometrial abncenn, Septc pelvic thlrombophllebitn
Necrotsing fasciits
Necrotc infecton of superfcial fascia thlat npreadn rapidly aloog tnnue plaoen to thle abdo hall, butock,
aod/or thlig hl
Preneotatoo – Skio oedema, blue-brown discolouraton, or fraok g aog reoe, lonn of neonatoo or
hlyperenthlenia clioical diag oonin)
Rx – Aobx, ag g rennive surgical debridement
Complicatoon – neptcaemia, circulatory failure, Materoal mortality 5%))
Psychiatric complaints
Post-partum blues – mild traonieot deprennioo hhlichl in commoo afer delivery >5%) of homeo) – No Rx
oeeded
Post-partum depression
o Commoo: 8-105) of all pont-partum homeo
o Rink factorn - Prior deprennioo 3%) rink), Prior pont-partum deprennioo 7%-85) rink)
o Oonet of nymptomn 2-3 moothln afer preg oaocy
o Rx – Spootaoeoun renolutoo hithlio 6-102 moothln), moothlly folloh-up, nupportve care, medn if
oecennary
Post-partum psychosis
o Rare: 10-2 per 10%%% live birthln
o Rink factorn – Primiparity, Youog ag e, PMH or FHx of meotal illoenn, Prior pont-partum pnychlonin
25-3%) rink)
o Oonet of nymptomn 10%-104 dayn afer preg oaocy
o Rx – Honpitalinatoo, Phlarmacolog ic thlerapy aotpnychlotcn), ECT electrocoovulnaot thlerapy)
Breast engorgement
Occurn 2-4 days post-partum
Partcularly io thlone hhlo areo’t breantfeediog or if it in ioterrupted an thlin leadn to vascular and lymphatc
stasis
Preneotatoo – Heavy, teoder, frm, harm breantn
Rx – Tig hlt fiog bra, Ice packn, Aoalg enicn, Bromocriptoe dopamioe ag ooint hhlichl iohlibitn PRL)
Mastts
Occurn 3-4 weeks post-partum
Reg iooal iofectoo of breant pareochlyma unually Staph aureus)
Uocommoo, but more no io primiparoun homeo
Preneotatoo - fever, chlilln, focal breant erythlema/oedema/teoderoenn clioical diag oonin)
Rx – Cootoue breantfeediog overcomen ductal obntructoo), Aoalg enia, Flucloxacillin PO
Complicatoon – Abncenn 10%)) hhlichl requiren nurg ical draioag e
Endometrits
Polymicrobial infecton of thle eodometrium thlat ofeo alno iovaden myometrium
Seeo afer 5) of vag ioal deliverien, aod afer 25-5%) of C-secton deliverien
Rink factorn – C-nectoo, proloog ed ROM, multple vag ioal examioatoon, maoual placeota removal, ioteroal
foetal mooitoriog
Rx – IV Broad spec Anbx – Cliodamycio aod Geotamycio Stop hhleo afebrile for 24-48hlrn), D&C if
retaioed productn nunpected)
Complicatoon – Eodometrial abncenn, Septc pelvic thlrombophllebitn
Necrotsing fasciits
Necrotc infecton of superfcial fascia thlat npreadn rapidly aloog tnnue plaoen to thle abdo hall, butock,
aod/or thlig hl
Preneotatoo – Skio oedema, blue-brown discolouraton, or fraok g aog reoe, lonn of neonatoo or
hlyperenthlenia clioical diag oonin)
Rx – Aobx, ag g rennive surgical debridement
Complicatoon – neptcaemia, circulatory failure, Materoal mortality 5%))
Psychiatric complaints
Post-partum blues – mild traonieot deprennioo hhlichl in commoo afer delivery >5%) of homeo) – No Rx
oeeded
Post-partum depression
o Commoo: 8-105) of all pont-partum homeo
o Rink factorn - Prior deprennioo 3%) rink), Prior pont-partum deprennioo 7%-85) rink)
o Oonet of nymptomn 2-3 moothln afer preg oaocy
o Rx – Spootaoeoun renolutoo hithlio 6-102 moothln), moothlly folloh-up, nupportve care, medn if
oecennary
Post-partum psychosis
o Rare: 10-2 per 10%%% live birthln
o Rink factorn – Primiparity, Youog ag e, PMH or FHx of meotal illoenn, Prior pont-partum pnychlonin
25-3%) rink)
o Oonet of nymptomn 10%-104 dayn afer preg oaocy
o Rx – Honpitalinatoo, Phlarmacolog ic thlerapy aotpnychlotcn), ECT electrocoovulnaot thlerapy)
