Medical brain notes 11

  Sub-Involution   This is defined as a delay of the uterus to return to their pre-gravid state, usually due to retained products of conception and infection.   Causes   ·                Anything interfering with proper contraction of the uterus e.g. full bladder and rectum and retained product.   ·                Local uterine infection   ·                Presence of uterine fibroid   ·                Grande multiparity   Signs And Symptoms ·                Bulky and soft uterus   ·                Lochia are profuse and reddish brown.   ·                The fundal height remains stationary for a few days.   Management   The midwife should palpate the uterus to exclude tenderness which may be due to infection. The suprapubic area should be percussed to exclude full bladder. Constipation should also be excluded; early ambulation of the patient should be encouraged. The doctor may order a course of ergomotrine 0.5mg x 3 days orally analgesics e.g. panadol 2 tablets when necessary. The lo

  Definition   Excessive bleeding from the genital tract of 500mls or more after the birth of the baby, or with less but deterioration in the patient’s condition.   Classification 1.             Primary Post Partum haemorrhage   2.             Secondary post Partum haemorrhage.   Primary Post Partum heamorrhage when it occurs within 24 hours after delivery.  There are two types of PPH 1.             Atonic Haemorrhage – Bleeding from the placenta sit e.   2.             Traumatic PPH – Bleeding from laceration of the gen ital tract.   3.             Blood dyscracia. (Developmental disorder of the blood)   Atonic Haemorrhage   Bleeding is due to inability of the uterine muscle to contract effectively causes.   1. Atonic uterus: leading to incomplete separation of placenta 30 prevent effective retraction of the placental site.   ·                Common with prolonged labour   ·                Prolonged and deep anaesthesia.   ·                Overstretching of the uterus – e.g. Polyhydra