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Divine intervention OBGYN Already Rated A+ 33yo post partum wellness check up - what to talk about 1) Breast Feeding 2) Baby blues What cannot give when breast feeding? OCP - with estrogen - only give Progesterone = Depo or Medroxyprogesterone MOA of progestins increase vascularizatio...

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  • September 27, 2024
  • 25
  • 2024/2025
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Divine intervention OBGYN Already Rated A+
33yo post partum wellness check up - what to talk about

1) Breast Feeding
2) Baby blues

What cannot give when breast feeding?

OCP - with estrogen

- only give Progesterone = Depo or Medroxyprogesterone



MOA of progestins

increase vascularization of the endometrium and thicken cervical mucus

breast feeding is associated with decreased risk of

breast cancer (prolactin inhibits estrogen production by decreasing GnRH)
Ovarian cancer (same as above)

Breast feeding is contra-indicated when

1) Mom has infections

- TB

- HIV

-active herpes lesions on breast

2) Baby has galactosemia = cannot digest milk

should moms with mastitis breast feed

yes

mastitis treatment

dicloxacillin

22 yo f is tearful after delivery, she has been breastfeeding and taking care of the baby

Postpartum blues

22 yo f is brought to ED with her husband after she taped a radio to her head saying that she is receiving
messages to sacrifice her baby to end world hunger

dx and tx

,post partum psychosis

antipsychotic and involuntary hospitalization (to protect baby)

post partum blues vs depression

postpartum blues: begins and ends within the first 2 weeks postpartum

postpartum depression: delayed from 2 weeks to 12 months postpartum

post partum C-section that presents with:
- Vitals = normal with fever
- lower abdo pain
- vaginal discharge = foul smell
- fever

= endometritis

- fever = infection

- lower abdominal pain = abodmen oriented

Greatest risk factor = C-section

greatest risk factor for endometritis

C section (introduces microbes to the uterus)

treatment for endometritis

Clindamycin and Gentamycin

Endometritis

Endometritis is

= inflammation of the inner lining of the uterus (endometrium).

Symptoms may include:

- fever,

- lower abdominal pain, and

- abnormal vaginal bleeding or discharge.

It is the most common cause of infection after childbirth.

Chorioamniocitis

Chorioamniocitis =
- intra-amniotic infection (IAI) is an inflammation of the fetal membranes (amnion and chorion) due to a
bacterial infection.

, It typically results from bacteria ascending from the vagina into the uterus and is most often

associated with prolonged rupture of membranes

Baby >160HR Mom = fever - foul smelling discharge

- what?
- Risk factor?
- Tx?

Chorioamniocitis

- biggest risk factor = prolonged rupture of membranes

---- because this allows for more exposure of infection

Tx = CAG = Ampicillin and Gentamycin

stillborn and abscesses throughout the body
- what?
- why?

Dx = granulomatosis infantiseptica

- caused by congenital Listeria




woman presenting with amenorrhea or a woman with concerning signs for an ectopic pregnancy... next
best step

check HCG

Pregnancy clues
- blue / purple cervix

Chadwick's sign
- present 6-8 wks post conception

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