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Obstetrics: puerperium — normal and abnormal, lactation

Obstetrics and Gynecology · MBBS

Study notes

Day 5 — fever, foul lochia, tender uterus; puerperal sepsis; antibiotics. Puerperal sepsis (fever >38 — endometritis — foul lochia, tender uterus: broad antibiotics — clindamycin + gentamicin; retained products — evacuate): normal puerperium (6 weeks — involution — fundus descends; lochia — rubra 3–4d → serosa → alba — 2–4 weeks; afterpains; vitals). Lactation (colostrum — first milk — antibodies; exclusive 6 months — on demand — 8–12 feeds; latching — areola; problems — cracked nipple — correct latch; engorgement — frequent feeds; mastitis — painful red wedge — continue feeding + cloxacillin; abscess — drain). Contraception (LAM — 6mo exclusive; PPIUCD — immediate; condoms). The foul lochia with fever is endometritis — antibiotics.

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