Postpartum Complications Overview

Postpartum Complications

• Postpartum Psychosis: Characterized by a loss of contact with reality, often with denial of childbirth, thoughts of harming the infant, or claims of the child not belonging to the mother. Requires immediate professional psychiatric intervention.
• Postpartum Blues: Normal reaction to childbirth, characterized by feelings of sadness, anxiety, and/or tearfulness. Usually resolves within a few weeks without intervention.
• Postpartum Depression: More severe than "the blues," marked by feelings of sadness, hopelessness, and difficulty caring for the baby. Requires professional help.
• Postpartum Hemorrhage: Significant blood loss (over 500 mL within 24 hours) after childbirth. Often caused by uterine atony (lack of muscle tone).
• Puerperal Infection: Infection in the uterus or other reproductive organs after childbirth. Characterized by a temperature above 100.4° F (38.0° C).
• Thrombophlebitis: Inflammation of a blood vessel. Can result from an infection and require bed rest and anticoagulant therapy. Never massage the affected leg.
• Mastitis: Breast infection, characterized by pain, swelling, and redness. Requires antibiotic therapy.
• Newborn with a Challenge: Child with developmental or physical issues needs extra support from nurses.

Checklist Questions

• Checkpoint Question 25.3: Statement "My baby has the devil's eyes" is most suggestive of postpartum psychosis.

Key Points for Review

• Establishing a supportive family-newborn relationship can be challenging with postpartum complications. Investigate support systems for the family.
• Hemorrhage (significant blood loss) is a major danger. Uterine atony is commonly the cause.
• Postpartum infection (temperature greater than 100.4°F) is a concern requiring treatment.
• Thrombophlebitis (inflammation of a blood vessel) responds to rest with moist heat and anticoagulants.

Critical Thinking Exercises

• Critical Thinking Exercise 1: Early action to prevent postpartum hemorrhage would have been to address the mother's heavy vaginal bleeding by monitoring and preventing any further blood loss. Prompt action would be to initiate appropriate treatment immediately.

• Critical Thinking Exercise 2: Infants with a urinary tract infection need appropriate medical treatment to alleviate the condition rather than self-treating.

• Critical Thinking Exercise 3: Develop a plan to reduce thrombo-phlebitis risk by including proper measures to prevent clots and complications.

References

• None supplied

High-Risk Newborns

• Apnea: Periods of no breathing for more than 20 seconds. Requires observation and possible interventions.
• Hypothermia: Inability to regulate body temperature, making them vulnerable to cold.
• Impaired Gas Exchange: Difficulty distributing oxygen effectively to the body's tissues.
• Risk for Deficient Fluid Volume: Because of immature kidneys and high insensible water loss, they may need more fluids.
• Imbalanced Nutrition: High caloric needs may require more frequent feedings or total parenteral nutrition.