Divine intervention OBGYN Already Rated A+
33yo post partum wellness check up - what to talk about
1) Breast Feeding
2) Baby blues
What cannot give when breast feeding?
OCP - with estrogen
- only give Progesterone = Depo or Medroxyprogesterone
MOA of progestins
increase vascularization of the endometrium and thicken cervical mucus
breast feeding is associated with decreased risk of
breast cancer (prolactin inhibits estrogen production by decreasing GnRH)
Ovarian cancer (same as above)
Breast feeding is contra-indicated when
1) Mom has infections
- TB
- HIV
-active herpes lesions on breast
2) Baby has galactosemia = cannot digest milk
should moms with mastitis breast feed
yes
mastitis treatment
dicloxacillin
22 yo f is tearful after delivery, she has been breastfeeding and taking care of the baby
Postpartum blues
22 yo f is brought to ED with her husband after she taped a radio to her head saying that she is receiving
messages to sacrifice her baby to end world hunger
dx and tx
,post partum psychosis
antipsychotic and involuntary hospitalization (to protect baby)
post partum blues vs depression
postpartum blues: begins and ends within the first 2 weeks postpartum
postpartum depression: delayed from 2 weeks to 12 months postpartum
post partum C-section that presents with:
- Vitals = normal with fever
- lower abdo pain
- vaginal discharge = foul smell
- fever
= endometritis
- fever = infection
- lower abdominal pain = abodmen oriented
Greatest risk factor = C-section
greatest risk factor for endometritis
C section (introduces microbes to the uterus)
treatment for endometritis
Clindamycin and Gentamycin
Endometritis
Endometritis is
= inflammation of the inner lining of the uterus (endometrium).
Symptoms may include:
- fever,
- lower abdominal pain, and
- abnormal vaginal bleeding or discharge.
It is the most common cause of infection after childbirth.
Chorioamniocitis
Chorioamniocitis =
- intra-amniotic infection (IAI) is an inflammation of the fetal membranes (amnion and chorion) due to a
bacterial infection.
, It typically results from bacteria ascending from the vagina into the uterus and is most often
associated with prolonged rupture of membranes
Baby >160HR Mom = fever - foul smelling discharge
- what?
- Risk factor?
- Tx?
Chorioamniocitis
- biggest risk factor = prolonged rupture of membranes
---- because this allows for more exposure of infection
Tx = CAG = Ampicillin and Gentamycin
stillborn and abscesses throughout the body
- what?
- why?
Dx = granulomatosis infantiseptica
- caused by congenital Listeria
woman presenting with amenorrhea or a woman with concerning signs for an ectopic pregnancy... next
best step
check HCG
Pregnancy clues
- blue / purple cervix
Chadwick's sign
- present 6-8 wks post conception
33yo post partum wellness check up - what to talk about
1) Breast Feeding
2) Baby blues
What cannot give when breast feeding?
OCP - with estrogen
- only give Progesterone = Depo or Medroxyprogesterone
MOA of progestins
increase vascularization of the endometrium and thicken cervical mucus
breast feeding is associated with decreased risk of
breast cancer (prolactin inhibits estrogen production by decreasing GnRH)
Ovarian cancer (same as above)
Breast feeding is contra-indicated when
1) Mom has infections
- TB
- HIV
-active herpes lesions on breast
2) Baby has galactosemia = cannot digest milk
should moms with mastitis breast feed
yes
mastitis treatment
dicloxacillin
22 yo f is tearful after delivery, she has been breastfeeding and taking care of the baby
Postpartum blues
22 yo f is brought to ED with her husband after she taped a radio to her head saying that she is receiving
messages to sacrifice her baby to end world hunger
dx and tx
,post partum psychosis
antipsychotic and involuntary hospitalization (to protect baby)
post partum blues vs depression
postpartum blues: begins and ends within the first 2 weeks postpartum
postpartum depression: delayed from 2 weeks to 12 months postpartum
post partum C-section that presents with:
- Vitals = normal with fever
- lower abdo pain
- vaginal discharge = foul smell
- fever
= endometritis
- fever = infection
- lower abdominal pain = abodmen oriented
Greatest risk factor = C-section
greatest risk factor for endometritis
C section (introduces microbes to the uterus)
treatment for endometritis
Clindamycin and Gentamycin
Endometritis
Endometritis is
= inflammation of the inner lining of the uterus (endometrium).
Symptoms may include:
- fever,
- lower abdominal pain, and
- abnormal vaginal bleeding or discharge.
It is the most common cause of infection after childbirth.
Chorioamniocitis
Chorioamniocitis =
- intra-amniotic infection (IAI) is an inflammation of the fetal membranes (amnion and chorion) due to a
bacterial infection.
, It typically results from bacteria ascending from the vagina into the uterus and is most often
associated with prolonged rupture of membranes
Baby >160HR Mom = fever - foul smelling discharge
- what?
- Risk factor?
- Tx?
Chorioamniocitis
- biggest risk factor = prolonged rupture of membranes
---- because this allows for more exposure of infection
Tx = CAG = Ampicillin and Gentamycin
stillborn and abscesses throughout the body
- what?
- why?
Dx = granulomatosis infantiseptica
- caused by congenital Listeria
woman presenting with amenorrhea or a woman with concerning signs for an ectopic pregnancy... next
best step
check HCG
Pregnancy clues
- blue / purple cervix
Chadwick's sign
- present 6-8 wks post conception
