Post natal care

post natal care

1. POSTNATAL CARE

2. POSTNATAL CARE Postnatal care includes systemic examination of mother and the baby and appropriate advice given to the mother during postpartum period. First postnatal advice and examination is given on discharge from hospital and second is conducted at the end of 6 th week postpartum

3. Aims and objectives To assess the health status of mother .medical disorders like diabetes hypertension thyroid disorders should be reassessed To detect and treat any gynecological condition arising out of obstetric legacy To note the progress of the baby including the immunization schedule of the baby To impart family planning guidance

4. Procedure Examination of mother Advice given to mother Examination of baby and advice

5. Examination of mother Routine examination – it includes recording weight, pallor , B.P,tone of abdominal muscles and examination of breast . Pelvic examination only when indicated . The following should be noted: a cervical smear may be taken for exfoliative cytological examination if it is not done previously . Laboratory examination depending on the clinical need may be advised .

6. EXAMINATION OF BABY Should be conducted by pediatrician .Progress of the baby is evaluated and preventive and curative steps are to be taken . Immunization of the baby is started . ADVICE GIVEN : general – if patient health is sound she is allowed to do her usual duties . -postpartum exercise may be continued for another 4-6 wks . -

7. ADVICE GIVEN general – if patient health is sound she is allowed to do her usual duties . -postpartum exercise may be continued for another 4-6 wks. . VACCINATION MMR ,HEP B To evaluate the progress of baby periodically and to continue breastfeeding for 6 months . FAMILY PLANNING COUNSELLING AND GUIDENCE .

8. MANAGEMENT OF SOME COMMON GYNECOLOGICAL PROBLEMS IRREGULAR VAGINAL BLEEDING : heavy bleeding may occur 4-6 weeks after delivery following uneventful period. -Persistence of bleeding dating back from childbirth is likely due to retained bits of conceptus and usually require USG examination followed by dilatation and curettage operation LEUKORRHEA :profuse white discharge might be due to ill health ,vaginitis ,cervicitis or subinvolution . -improvement of general health and specific therapy cure the condition.

9. CERVICAL ECTOPY : met during this period without any symptom should not be treated surgically. - Hormone induced ectopy takes about 12 wks to regress .Thus asymptomatic ectopy should be examined again after 6 wks and if still persists ,cauterization is to be considered.

10. BACKACHE : Mostly due to sacroiliac or lumbosacral strain .Backache over the sacrum is likely due to pelvic pathology. -but if it is over lumber region that may be due to orthopedic condition often relieved by physiotherapy. - RETROVERSION : seldom produces backache .if associated with sub involution a pessary is inserted after correcting the position and kept for 2 months - SLIGHT DEGREE OF UTERINE DESCENT :can be cured by effective pelvic floor exercise . However if prolapse is marked effective surgery can be done .

11. - URINARY AND ANAL INCONTINENCE : the women is examined for any sphincter injury .perineal exercises are advised .women with persistent symptom after 6 months need surgical treatment .