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