Postpartum Hemorrhage, Endometritis, Mastitis, Mental Health Concerns - Maternity | @LevelUpRN

Level Up RN
30 Nov 202120:05
EducationalLearning
32 Likes 10 Comments

TLDRIn this informative video, Meris from Level Up RN discusses various postpartum complications, including postpartum hemorrhage, endometritis, mastitis, and mental health concerns. She defines postpartum hemorrhage based on the type of delivery and lists risk factors such as uterine atony and retained placental fragments. Treatment involves uterine stimulants and, in severe cases, surgical intervention. Endometritis, an infection of the uterine lining, is more common after C-sections and is treated with antibiotics. Mastitis, an infection in breastfeeding mothers, is treated with antibiotics and analgesics, with prevention focusing on proper latch and hand hygiene. Mental health issues like baby blues, postpartum depression, and postpartum psychosis are also addressed, with the latter being a serious condition requiring immediate medical attention. The video emphasizes the importance of routine screening and support for postpartum mental health.

Takeaways
  • 🩸 Postpartum hemorrhage is defined as a blood loss of more than 500 ml for vaginal delivery and more than 1,000 ml for C-section.
  • 🚨 Uterine atony is a significant risk factor for postpartum hemorrhage, characterized by a boggy fundus instead of a firm one.
  • 🤰 Risk factors for postpartum hemorrhage include birth canal trauma, precipitous delivery, retained placental fragments, and coagulopathies.
  • 📈 Signs of postpartum hemorrhage include rapid blood loss, large blood clots, and symptoms of hypovolemic shock like tachycardia and hypotension.
  • 💊 Treatment for postpartum hemorrhage involves uterine stimulants such as oxytocin, Methylergonovine, Misoprostol, and Carboprost.
  • 🤰 Endometritis is an infection or inflammation of the uterine lining and is more common after C-sections and in cases of retained placental fragments.
  • 🤒 Signs of endometritis include fever, suprapubic pain, foul-smelling lochia, and tachycardia.
  • 💊 Treatment for endometritis typically involves IV or oral antibiotics and analgesics to manage pain.
  • 🍼 Mastitis is an infection and inflammation of the breast, often caused by infrequent feeding or clogged milk ducts.
  • 🤕 Signs of mastitis include flu-like symptoms, unilateral breast pain, swelling, and erythema.
  • 💊 Treatment for mastitis involves antibiotics and analgesics, with patient education on prevention methods being crucial.
  • 🧘 Postpartum mental health concerns range from baby blues, which are temporary mood swings, to postpartum depression and psychosis, which require intervention.
  • 📉 Postpartum depression is identified by persistent sadness and mood swings lasting more than two weeks, while postpartum psychosis presents with hallucinations, delusions, and paranoia.
  • 🛡 In cases of postpartum psychosis, immediate action is necessary to ensure the safety of both the mother and the infant, involving treatments like antipsychotics and psychotherapy.
Q & A

  • What is postpartum hemorrhage defined as for a vaginal delivery?

    -Postpartum hemorrhage for a vaginal delivery is defined as greater than 500 mls of blood loss.

  • What is a significant risk factor for postpartum hemorrhage?

    -Uterine atony, which is characterized by a lack of tone in the uterus, resulting in a boggy fundus, is a significant risk factor for postpartum hemorrhage.

  • What is the treatment for postpartum hemorrhage?

    -The treatment for postpartum hemorrhage includes the use of uterine stimulants such as oxytocin, Methylergonovine (Methergin), Misoprostol, and Carboprost (Hemabate), as well as bimanual compression, uterine packing, and in severe cases, surgical intervention.

  • What is endometritis and what are its risk factors?

    -Endometritis is an infection or inflammation of the endometrium, the lining of the uterus. Risk factors include C-section deliveries, chorioamnionitis, retained placental fragments, premature rupture of membranes, prolonged labor, internal fetal monitoring, and multiple cervical examinations.

  • What are the signs and symptoms of endometritis?

    -Signs and symptoms of endometritis include fever, suprapubic pain and tenderness, excessive and malodorous lochia, tachycardia, and hypotension.

  • What is the primary treatment for endometritis?

    -The primary treatment for endometritis is IV or oral antibiotics, and analgesics to manage pain.

  • What is mastitis and what are its common risk factors?

    -Mastitis is an infection and inflammation of the breast, commonly occurring in breastfeeding patients who cannot fully drain the breast. Risk factors include infrequent feeding, clogged milk ducts, nipple damage, and poor hand hygiene.

  • What are the typical signs and symptoms of mastitis?

    -Typical signs and symptoms of mastitis include flu-like symptoms such as malaise, fatigue, body aches, and fever, as well as localized unilateral pain, swelling, and erythema of the breast.

  • What are the Edinburgh Postnatal Depression Scale (EPDS) used for?

    -The Edinburgh Postnatal Depression Scale (EPDS) is used to screen patients for postpartum depression during their postpartum period.

  • What is considered normal in terms of mood swings after childbirth?

    -Baby blues, which are mood swings or crying spells that last for about one to two weeks following delivery, are considered normal.

  • What is postpartum psychosis and what are its typical timeframe and risk factors?

    -Postpartum psychosis is a severe mental health condition that typically occurs within two weeks of delivery. Risk factors include a history of bipolar disorder, and signs and symptoms include hallucinations, delusions, confusion, and paranoia.

  • How should healthcare providers approach the topic of postpartum depression with patients?

    -Healthcare providers should routinely screen patients using tools like the EPDS and approach the topic in a non-judgmental and supportive manner, emphasizing the importance of the mother's mental health for her own well-being and that of her infant.

Outlines
00:00
🤰 Postpartum Hemorrhage Overview

Meris from Level Up RN introduces the topic of postpartum complications, focusing on postpartum hemorrhage. She defines it in terms of blood loss for both vaginal and C-section deliveries and discusses risk factors such as uterine atony, birth canal trauma, precipitous delivery, retained placental fragments, and coagulopathies. Meris emphasizes the importance of recognizing signs and symptoms like rapid blood loss, a boggy fundus, and large blood clots. She also touches on the treatment involving uterine stimulants and other medical interventions.

05:06
🏥 Postpartum Hemorrhage Treatment and Endometritis

The video continues with the treatment options for postpartum hemorrhage, including bimanual compression, uterine packing, and surgical intervention. It then transitions to another postpartum complication, endometritis, which is an infection or inflammation of the uterine lining. Meris shares her personal experience with endometritis and outlines risk factors such as C-section deliveries, chorioamnionitis, retained placental fragments, and internal fetal monitoring. The signs and symptoms include fever, pain, foul-smelling lochia, and tachycardia. Treatment typically involves IV or oral antibiotics and analgesics.

10:09
🍼 Mastitis and Breastfeeding Challenges

Meris discusses mastitis, an infection and inflammation of the breast common in breastfeeding patients. She covers risk factors like infrequent feeding, clogged milk ducts, nipple damage, and poor hand hygiene. Symptoms of mastitis include flu-like symptoms, localized pain, swelling, and redness of the breast. The treatment involves antibiotics and analgesics. Meris also provides patient teaching tips for prevention and management, such as maintaining good hand hygiene, proper latch, feeding from both breasts, applying heat, and ensuring complete emptying of the breasts.

15:15
🧘 Postpartum Mental Health Concerns

The video addresses mental health concerns postpartum, including the baby blues, postpartum depression (PPD), and postpartum psychosis. Meris differentiates between these conditions based on duration and severity. She shares her personal story of experiencing severe PPD and the importance of screening with tools like the Edinburgh Depression Scale. The video highlights the need for a supportive approach in discussing mental health with patients. Postpartum psychosis, the most severe condition, is characterized by hallucinations and delusions and requires immediate medical attention, including antipsychotics and mood stabilizers.

Mindmap
Keywords
💡Postpartum hemorrhage
Postpartum hemorrhage refers to excessive bleeding after childbirth, defined as a loss of more than 500 ml for vaginal delivery and more than 1,000 ml for a C-section. It is a critical condition that can arise due to various risk factors such as uterine atony, birth canal trauma, and retained placental fragments. In the video, it is emphasized as a significant postpartum complication that requires prompt identification and treatment to prevent severe health risks for the mother.
💡Uterine atony
Uterine atony is a condition where the uterus lacks the necessary tone or firmness after delivery, leading to a 'boggy fundus' and increased risk of postpartum hemorrhage. It is highlighted in the video as a primary risk factor that health professionals should closely monitor due to its strong association with excessive bleeding post-delivery.
💡Endometritis
Endometritis is an infection or inflammation of the endometrium, the lining of the uterus, which can be very painful and distressing for the patient. The video discusses it as a postpartum complication that can affect patients who have undergone a C-section or have experienced other risk factors such as retained placental fragments or prolonged rupture of membranes. It is treated with antibiotics and is a significant concern due to its potential impact on maternal health.
💡Mastitis
Mastitis is an infection and inflammation of the breast tissue, commonly associated with breastfeeding mothers who may have inadequate milk drainage. The video script mentions risk factors like infrequent feeding, clogged milk ducts, and nipple damage. Treatment typically involves antibiotics and analgesics, and patient education on prevention and management is crucial to avoid complications.
💡Mental health concerns
The video addresses various mental health issues that may arise postpartum, including the 'baby blues', postpartum depression (PPD), and postpartum psychosis. These conditions are significant as they can affect the mother's well-being and her ability to care for her infant. The video emphasizes the importance of screening and support to ensure the safety and health of both the mother and the baby.
💡Baby blues
Baby blues are temporary mood swings or crying spells that occur within one to two weeks following childbirth. The video describes it as a normal reaction that is expected and typically resolves on its own. However, it is important to monitor these symptoms to ensure they do not progress into more severe conditions like postpartum depression.
💡Postpartum depression (PPD)
PPD is a more persistent and severe form of sadness and mood swings that can last for up to one year after delivery. Unlike the baby blues, PPD is not considered normal and requires intervention. The video script discusses the use of the Edinburgh Postnatal Depression Scale (EPDS) for screening and the importance of addressing this condition to support the mother and protect the infant.
💡Postpartum psychosis
Postpartum psychosis is a rare but serious mental health emergency that can occur within two weeks of delivery. It is characterized by hallucinations, delusions, confusion, and paranoia, posing a significant safety risk to both the mother and the infant. The video emphasizes the urgency of seeking professional help and the need for treatments like antipsychotics and mood stabilizers to ensure safety.
💡Risk factors
Risk factors are specific conditions or events that increase the likelihood of developing a particular health issue. In the context of the video, risk factors are discussed for various postpartum complications, such as uterine atony for postpartum hemorrhage, C-section for endometritis, and a history of bipolar disorder for postpartum psychosis. Identifying and understanding these risk factors is crucial for prevention and early intervention.
💡Treatment
The video outlines treatments for different postpartum complications, emphasizing the importance of prompt and appropriate medical care. For postpartum hemorrhage, uterine stimulants like oxytocin are used. Endometritis is treated with antibiotics, while mastitis often requires antibiotics and analgesics. For mental health concerns, therapies like psychotherapy and medications such as antipsychotics and mood stabilizers may be necessary.
💡Nursing care
Nursing care involves the various supportive actions taken by nurses to ensure the well-being of patients. In the video, it is mentioned in the context of postpartum hemorrhage, where nursing care includes massaging the fundus, administering oxygen and IV fluids, and elevating the patient's legs to aid blood flow. This highlights the multifaceted role of nursing in patient recovery and the importance of comprehensive care post-delivery.
Highlights

Postpartum hemorrhage is defined as greater than 500 mls of blood loss for a vaginal delivery and greater than 1,000 mls for a C-section.

Risk factors for postpartum hemorrhage include uterine atony, birth canal trauma, precipitous delivery, and retained placental fragments.

Signs of postpartum hemorrhage include saturating a pad in less than 15 minutes, a soft or boggy fundus, and passing large blood clots.

Treatment for postpartum hemorrhage involves uterine stimulants like oxytocin, Methylergonovine, Misoprostol, and Carboprost.

Bimanual compression and uterine packing are additional methods to control postpartum hemorrhage.

Endometritis is an infection or inflammation of the endometrium, the lining of the uterus, and is marked by symptoms like fever and malodorous lochia.

Risk factors for endometritis include C-section delivery, chorioamnionitis, retained placental fragments, and internal fetal monitoring.

Treatment for endometritis involves IV or oral antibiotics and analgesics to manage pain.

Mastitis is an infection and inflammation of the breast, often resulting from inadequate milk drainage.

Risk factors for mastitis include infrequent feeding, clogged milk ducts, nipple damage, and poor hand hygiene.

Mastitis treatment includes antibiotics, analgesics, and patient education on prevention and proper milk expression.

Postpartum blues are mood swings or crying spells lasting one to two weeks after delivery, which are considered normal.

Postpartum depression (PPD) occurs within one year of delivery and involves persistent sadness and mood swings.

The Edinburgh Postnatal Depression Scale (EPDS) is used to screen patients for PPD.

Postpartum psychosis is a severe condition occurring within two weeks of delivery, characterized by hallucinations, delusions, and paranoia.

Treatment for postpartum psychosis includes antipsychotics, mood stabilizers, and psychotherapy to ensure the safety of the patient and infant.

Routine screening for mental health concerns postpartum is crucial and should not be seen as a judgment but as support.

Nurses should be prepared to act immediately to ensure the safety of patients experiencing postpartum psychosis.

Transcripts

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