POSTPARTUM INFECTIONS

Postpartum Infection

 local spread of colonized bacteria following vaginal delivery 

Endometritis

• lower abdominal tenderness

The most common postpartum infection | infection of the endometrium 

Characterized by ____________ on one or both side of the abdomen

• Adnexal

• Parametrial tenderness

• Bimanual examination

ENDOMETRITIS

• ________ and _________ _________elicited with ____________

• Temperature elevation (>38.3C)

• Chills

• Loss of appetite

• General malaise

• Dark brown foul

Endometritis 

• __________ (most commonly ______) 

  • For 2 consecutive 24-hour period excluding the first 24 hours after birth 

  • _____

  • _____

  • _____

• _______ smelling lochia 

Ultrasound

Antibiotics (Clindamycin)

Fowler’s position

Walking

ENDOMETRITIS MANAGEMENT

• ________ Confirms retained placental fragments as a cause of infection 

• ________(________) are given 

• ______ and ________ to drain lochia by gravity and avoid pooling of infected secretions.

• Tubal Scarring

• Interference of future fertility

ENDOMETRITIS COMPLICATIONS

• -

• -

Wound infection (episiotomy/incision)

• erythema

• edema

• foul smelling lochia 

More common with cesarean delivery 

• Pain and heat 

• _____

• _____

• Tenderness out of proportion to expected postpartum pain 

• Discharge from the wound or episiotomy site 

• _____

Open suture

• drainage

• debridement

• irrigation

WOUND INFECTION MANAGEMENT

• _______ to allow

  • -

  • -

  • -

• perineal packs

• broad spectrum antibiotics

• analgesics

• sitz bath

• Hubbard tank treatment

WOUND INFECTION MANAGEMENT

• -

• -

• -

• -

Hubbard Tank Treatment

hasten drainage and cleanse the areas

Mastitis

• nasal oral cavity

• staphylococcus aureus

• scant

• unilateral

• 7th postpartum day

Infection of the breast from _________ of the newborn acquired in the hospital (——————)

• Very Tender, Engorged, Erythematous Breasts

• Fever

• Breastmilk Becomes _____

• Infection frequently is _______

• Occurs as early as _________

• Breastfeeding position

• Exposing nipples to air

• vitamin E ointment

MASTITIS PREVENTION

• Proper __________

• Remove baby’s grasp on nipple before removing baby from the breasts 

• ________ for at least part of the day 

• Washing hands between handling perineal pads and touching the breasts

• Using ________ to soften nipples daily

• If has one cracked and one well nipple, encourage to begin breastfeeding on the unaffected nipple (when the infant sucks forcefully)

• antibiotics

• ice packs, analgesics, breast support for pain

• wet warm compress for inflammation/edema

• Continuous bf

• surgical drainage

MASTITIS MANAGEMENT

Urinary Tract Infection

Common to catheterized woman during childbirth 

• Burning on urination 

• Sometime blood in the urine

• Frequency in urination

• Suprapubic tenderness

• Elevated temperature

• Fluids

• Antibiotics (amoxicillin & ampicillin)

• Oral analgesics

UTI MANAGEMENT

• _______ ( to help flush infections from the bladder

• -

• -

• Tachypnea

• Rales

• Crackles

• Rhonchi

• Consolidation

RESPIRATORY TRACT INFECTION

• Perineal cellulitis

• Respiratory complications from anesthesia

• Retained products of conception

OTHER POSTAPRTAL INFECTIONS

• Rupture of membranes

• Postpartum hemorrhage

• Pre-existing anemia

• Internal

• Uterine exploration

POSTPARTAL INFECTION

• Risk Factors

  • ____________ more than 24 hours before birth

  • Retained placental fragments

  • ____________

  • ____________

  • Prolonged and difficult labor particularly with instrument births

  • ______ fetal heart monitoring

  • Local vaginal infection

  • _______ after birth

• Flank pain, dysuria, frequency

• Erythema and drainage

• Cough, pleuritic chest pain, dyspnea - pulmonary embolus

POSTPARTAL INFECTION

• Signs and Symptoms

  • UTI:

  • Surgical Incision/episiotomy:

  • Respiratory infection/_________

• Antibiotics after C and S test

• Pain meds

POSTPARTAL INFECTION

• Treatment