Observaties op indicatie eerste 7 dagen pp:
- Vitale parameters
- Navraag vaccinatie MMR binnen de 72h bij seronegatieve moeders
- Rhesusimmunisatie: anti-D-immunoglobulines (al ok indien ZH bevalling)
2. Zorgen voor de baby postpartum
Observatie baby:
- Gewicht
- Vitale parameters
- Mictie
- Defaecatie
- Huid
- Vitamine D & K
- Metabole screening
- Vaccinatie hepatitis B
1
, Risicodetectie bij vermoeden pathologie:
- Gewichtsverlies (-10%)
- Icterus
- Convulsies
- Ademhaling meer dan 60/’
- Ernstige tirage
- Geen spontane bewegingen
- Koorts hoger dan 37,5 of juist minder dan 36,5°C
Hoofdstuk 2: Koorts, infecties
1. Gunstige omstandigheden om infecties aan te gaan maken
De döderleinbacteriën ontbrenen vaginale bacterie die dode cellen opkuist
(afwezigheid leidt vaak tot schimmelinfectie)
pH-waarde is gestegen (normaalwaarde 7)
Cervix is nog steeds open
Er is geen cervix slijmprop aanwezig
Baarmoeder heeft een groot wondoppervlak & stolsels
Algemeen verminderde weerstand door vermoeidheid
Ernstig bloedverlies
2. Genitale infecties
Endomyometris = ontsteking van het endometrium of myometrium
Oorzaken: - Pathogene kiemen in de baarmoederholte
- Fout in asepsis (tijdens arbeid, partus)
Parametritis = bindweefsel rond BM is ontstoken
Symptomen: - Hoge koorts
3
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