Complications Of Postpartum. Postpartum Hemorrhage. Postpartum Hemorrhage. Early Occurs when blood loss is greater than 500 ml. in the first 24 hours after a vaginal delivery or greater than 1000 ml after a cesarean birth *Normal blood loss is about 300 - 500 ml.)
500 ml. in the first 24 hours after a vaginal delivery or greater than 1000 ml after a cesarean birth
*Normal blood loss is about 300 - 500 ml.)
The myometrium fails to contract and the uterus fills with blood because of the lack of pressure on the open blood
vessels of the placental site.
Excessive use of
Analgesia / Anesthesia
A boggy uterus that does not
respond to massage
Unusual pelvic discomfort or backache
(May inject the medications directly
into the uterus)
1. Spontaneous or Precipitous delivery
2. Size, Presentation, and Position of baby
3. Contracted Pelvis
4. Vulvar, perineal, and vaginal varices
1. Bright red bleeding where there is a
steady trickle of blood and the uterus
1. Meticulous inspection of the entire
lower birth canal
2. Suture any bleeders
3. Vaginal pack-- nurse may remove and
assess bleeding after removal
4. Blood replacement
Bleeding into the soft tissues surrounding
the episiotomy or laceration.
May follow forceps or vacuum extraction
*A unit or more of blood may
be in the hematoma
Major Symptom: PAIN- deep, severe, unrelieved, feelings of pressure
Many times bleeding is concealed. Major symptom is rectal pain and tachycardia.
May have to be incised and drained.
**Don’t pull on the cord unless the placenta has separated.
**Don’t use the fundus to “push the placenta out”
to be pulled and
Notify the Recovery Nurse what has occurred!
Care must be taken when massaging
All or part of the decidua basalis is absent and the Placenta grows directly into the uterine muscle.
separation of the placenta and fragments of
placental tissue retained.
Complains of chest pain
or severe dyspnea
Usually sign of Pulmonary Emboli
Infection of the genital tract that occurs within 28 days after abortion or delivery
Streptococcus Groups A and B
Clostridium, E. Coli
3. Prolonged labor
4. Urinary Tract Infections
5. Anemia and Hematomas
6. Excessive vaginal exams
7. P R O M
1.Temperature increase of 100.4 or higher
on any 2 consecutive days of the first
10 days post-partum, not including the
first 24 hours.
2. Foul smelling lochia, discharge
3. Malaise, Anorexia, Tachycardia, chills
4. Pelvic Pain
5. Elevated WBC
TREATMENT AND NURSING CARE
Signs and Symptoms:
Spiking a fever of 102 0 F to 104 0 F
Nausea and Vomiting
Abdominal Rigidity and Rebound Tenderness
nipples of milk
Entry for Bacteria Plugged ducts
Treatment, No Treatment
Problem will resolveBreast Abscess
Chills, Fever, Tachycardia
Hardness and Redness
Enlarged and tender
Rotate position of
baby on the breast
distended area to
Breast Feeding is stopped on the affected side, but may feed on the unaffected side.
Treatment: Incision and Drainage
The major causative organism of mastitis is
Mastitis develops mainly in ______________ who are nursing .
It is almost always ________________ and develops well
after the flow of milk has been established.
There are two types of mastitis. One that develops between
the lobes of the breast is called____________________.
The one that developswithin the lobes and ducts of the
breast is called __________________.
Mammary cellulitis mainly develops due to _______________.
Mammary adenitis develops when ____________________
of the breasts occurs. With improper treatment or no
treatment, mastitis can lead to ________________.
b. Cyclic compounds
c. MAO Inhibitors
e. Lithium, Depakene, Tegretol for bipolar
This helps mothers decrease their emotional distress and guide them in regaining their
Signs and Symptoms
How do the signs and symptoms of hematoma differ from those of uterine atony or a laceration?