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  • Postpartum-First 6 Weeks After: Childbirth

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    hady920
    42 tayangan22 halaman
    The document provides information on postpartum management. It discusses the physical changes a woman's body goes through in the 6 weeks following childbirth, including uterine involution where the uterus decreases in size. It outlines factors that enhance involution like breastfeeding. Signs of involution include the location of the uterine fundus. The document also describes the different lochia discharges a woman will experience and provides guidance on postpartum care after a vaginal birth, including using pads, sitting in warm water, and doing Kegel exercises. It discusses postpartum hemorrhage risks like uterine atony and outlines both pharmacological and non-pharmacological treatments.

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    The document provides information on postpartum management. It discusses the physical changes a woman's body goes through in the 6 weeks following childbirth, including uterine involution where the uterus decreases in size. It outlines factors that enhance involution like breastfeeding. Signs of involution include the location of the uterine fundus. The document also describes the different lochia discharges a woman will experience and provides guidance on postpartum care after a vaginal birth, including using pads, sitting in warm water, and doing Kegel exercises. It discusses postpartum hemorrhage risks like uterine atony and outlines both pharmacological and non-pharmacological treatments.

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    42 tayangan22 halaman

    Postpartum-First 6 Weeks After: Childbirth

    Diunggah oleh

    hady920
    The document provides information on postpartum management. It discusses the physical changes a woman's body goes through in the 6 weeks following childbirth, including uterine involution where the uterus decreases in size. It outlines factors that enhance involution like breastfeeding. Signs of involution include the location of the uterine fundus. The document also describes the different lochia discharges a woman will experience and provides guidance on postpartum care after a vaginal birth, including using pads, sitting in warm water, and doing Kegel exercises. It discusses postpartum hemorrhage risks like uterine atony and outlines both pharmacological and non-pharmacological treatments.

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    © All Rights Reserved
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    dari 22

    PostPartum

    Management

    Postpartum- first 6 weeks after


    childbirth

    PHYSICAL CHANGES DURING THE


    POSTPARTAL PERIOD
    INVOLUTION - IS THE PROCESS OF THE
    REDUCTION IN SIZE OF THE UTERUS AFTER
    DELIVERY TO PREPREGNANT SIZE CAUSED BY
    UTERINE CONTRACTIONS THAT CONSTRICT
    AND OCCLUDE BLOOD VESSELS AT THE
    PLACENTA SITE

    FACTORS THAT ENHANCE


    INVOLUTION
    UNCOMPLICATED LABOR & DELIVERY
    BREASTFEEDING
    EARLY AMBULATION
    COMPLETE EXPLUSION OF PLACENTA AND MEMBRANES

    Physiologic Changes of the Body


    after Delivery
    Uterus
    size of basketball during pregnancy to the size of a grapefruit right
    after delivery.
    weighs approximately 1000 g. In the 6 weeks following delivery, the
    uterus recedes to a weight of 50-100 g.

    FUNDUS
    TOP PORTION OF THE UTERUS
    A PALPABLE INDICATOR OF INVOLUTION
    BOGGY UTERUS-SOFT,RELAXED..CAN CAUSE HEMORRHAGE
    FUNDUS SHOULD BE FIRM

    Assessing Fundus

    FUNDUS
    LOCATION
    RIGHT AFTER DELIVERY THE FUNDUS IS MIDWAY BETWEEN
    SYMPHYSIS PUBIS AND UMBILICUS
    ONE HOUR AFTER DELIVERY THE FUNDUS RAISES TO THE
    UMBILICUS OR SLIGHTLY ABOVE-1CM AND REMAINS THERE
    FOR 24 HRS.

    Deviation of Fundus Location

    Vaginal Discharges

    Lochia Rubra- first discharge, red in color because of the


    large amount of blood it contains. It typically lasts no longer
    than 3-5 days.
    Lochia Serosa- thinned and turned brownish or pink in color.
    T contains serous exudate, erythrocytes, leukocytes and
    cervical mucus. 10th day after delivery. If it persists to some
    weeks after birth it can indicate PPH
    Lochia Alba- whitish or yellowish-white. It lasts from the 2 nd
    through the 3rd to sixth weeks after delivery. Continuation
    beyond a few weeks can indicate genital lesion.

    PostPartum Management

    Care after Vaginal Birth


    Use pads instead of tampons
    Ease cramps or afterpains with
    ibuprofen
    Put ice/cold pack for 10-20mins at
    a time if theres any swelling
    around the opening of the vagina
    Cleanse yourself with a gentle
    squeeze of warm water from a
    bottle
    Try sitting in a few inches of warm
    water (sitz bath) 3x a day and
    after bowel movements

    Try sitting in a few inches of warm


    water (sitz bath) 3x a day and
    after bowel movements
    Try sitting in a few inches of warm
    water (sitz bath) 3x a day and
    after bowel movements
    Ease the soreness of hemorrhoids
    and the area between your vagina
    and rectum with ice
    compress/witch haze pads
    Put on a clean peri pad each time
    you use the bathroom

    Care after Vaginal Birth

    TEACH CLIENT TO TIGHTEN


    BUTTOCKS THE SITTINGLAY ON
    SIDE
    ADMINSTER ANALGESICS
    KEGALS
    H2O,FIBER,& STOOL
    SOFTNERS,AMBULATE

    Kegels Exercise

    Uterine Atony

    is a loss of tone in theuterinemusculature. Normally,


    contraction of the uterine muscle compresses the vessels and
    reduces flow. This increases the likelihood of coagulation and
    prevents bleeds. Thus, lack of uterinemusclecontraction can
    cause an acutehemorrhage. Clinically, 75-80% ofpostpartum
    hemorrhages are due to uterine atony.

    Post Partum Hemorrhage Management

    Pharmacological
    Oxytocin infusion (10-40 units in 1L LRS or isotonic sodium
    chloride soltn)
    Carboprost 0.25mg IM every 15 minutes, 3 maximum doses
    Methylergonovine 0.2mg IM
    Misoprostol
    2010 Monte carlo Oral
    2010- rectal vs IV oxytocin

    Dinoprostone (Prostin E2)- 20 mg suppository can be given


    vaginally or rectally every 2 hours
    Fluid Resuscitation/Blood Products Replacement
    packed RBCs, Platelets. Fresh frozen plasma

    Non-Pharmacological
    Uterine packing -placed for 24-36 hours
    Uterine artery embolization performed under anesthesia
    B-lynch suture technique
    If conservative therapy fails:
    Bilateral uterine artery ligation
    Hypogastric artery ligation
    Emergency Hysterectomy is done if all treatment failed.

    The End

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