POST PREGANANCY COMPLICATIONS

1.POST PARTUM HAEMORRHAGE

The amount of bleeding from the genital tract following birth of the baby up to the end of puerperium which adversely affects the general condition of the patient rise in pulse rate with fall of blood pressure.The average blood loss is 500ml,1000ml and 1500ml respectively.

PRIMARY –TRUE POST PARTUM HAEMORRHAGE  bleeding occurs before expulsion of placenta.

SECONDARY-DELAYED OR LATE PUERPERAL HAEMORRHAGE bleeding occurs beyond 24 hours and with  In puerperium .

2.RETAINED PLACENTA

The placenta is said to be retained when it is not expelled out even 30 minutes after the birth of the baby.

3.PUERPERAL SEPSIS 

An infection of the genital tract which occurs as a complication of delivery  is termed as PUERPERAL SEPSIS 

Puerperal sepsis  is commonly due to -1.endometitis ,2.endomyometritis,3.endoparametritis combination of 3 is called as PELVIC CELLULITIS.

Micro organisms responsible for puerperal sepsis are-STREPTOCOCCUS HAEMOLYTICUS GROUP A (Toxic shock syndrome,caesarean section wound) STREPTOCOCCUS HAEMOLYTICUS  GROUP B in Neonatal deaths due to septicaemia ,respiratory diseases and meningitis.  

4.PUERPERAL PYREXIA

Arise of temperature reaching 100 degree F or more  on 2 seperarte occasions at 24 hours apart ,with in first 10 days following delivery is called PUERPERAL PYREXIA.

CAUSES-Puerperal sepsis,urinary tract infection(cystitis,pyelo nephritis),mastitis,pulmonary infection,septic pelvic thrombophlebitis etc

5.SUBINVOLUTION

When the involution is impaired or retarded it is called subinvolution.UTERUS is the most common organ affected in suninvolution 

CAUSES –Grand multiparity,hydramnios,maternal ill health,caesarean section,proplase of uterus and uterine fibroids etc

SIGNS AND SYMPTOMS –Abnormal lochial discharge,irregular or excessive uterine bleeding ,irregular cramps with rise of temperature.

6.URINARY COMPLICATIONS

  • Retention of urine
  • Incontinence of urine
  • Suppression of urine

7.BREAST COMPLICATIONS

  • Breast engorgement
  • Cracked and retracted nipple
  • Acute mastitis
  • Breast abscess

 8.PUERPERAL VENOUS THROMBOSIS

Thrombosis of the leg veins,and pelvic veins is one of the common and important complications in puerperium

9.PULMONARY EMBOLISM

Pulmonary embolism is the leading cause of maternal deaths.

10.PSYCHIATRIC DISORDERS DURING PUERPERIUM 

In the first 3 months after delivery ,incidence of maternal illness is high,incidence about 15-20% Sleep deprivation,massive post partum withdrawal,contribute to the risk.