POSTPARTUM PERIOD

PUERPERIUM
STAGE
PRESENTED BY:
GARIANDO, DANIEL
SARABAN, RASHIMA
GROUP TWO ESMAEL, RAMAIDHA
 What is

O V E R V I E W
PUERPERIUM
PERIOD?

The puerperium stage also

known as postpartum period is
commonly defined as the six
weeks after childbirth.
 THE
IMMEDIATE
PUERPERIUM
STAGES
OF
THE EARLY
POSTPARTUM PUERPERIUM

The post partum period has

been divided into:
THE REMOTE
PUERPERIUM
 POSTPARTUM POSTPARTUM
DEPRESSION PSYCHOSIS

POSTPARTUM
DISORDERS AND
COMPLICATION
POSTPARTUM POSTPARTUM
BLUES HEMORRHAGE
 POSTPARTUM

O V E R V I E W
DEPRESSION
A complex mix of physical,
emotional, and behavioral
changes that happen in
some women after giving
birth.
 POSTPARTUM DEPRESSION
PATHOPHYSIOLGY
The pathophysiology of PPD can be caused by
alterations of multiple biological and endocrine
systems, for example, the immunological
system, the hypothalamic-pituitary-adrenal axis
(HPA), and lactogenic hormones.
CLINICAL

POSTPARTUM DEPRESSION
MANIFESTATION
Depressed mood or severe mood swing
Difficulty bonding with your baby
Intense irritability and anger
Fear that you're not a good mother
Severe anxiety and panic attacks
Restlessness
Thoughts of harming yourself or your baby
Recurrent thoughts of death or suicide
NURSING

POSTPARTUM DEPRESSION
DIAGNOSIS
1. Risk for poor parenting related to dramatic hormone drop as
evidenced by intense irritability.

2. Sleep deprivation related to severe anxiety as evidenced by

restlessness.

3. Disturbed thought process related to inability to care for a

newborn as evidenced by emotional disturbance.
GENERAL NURSING

POSTPARTUM DEPRESSION
INTERVENTION
• Refer patient for psychological evaluation by primary care
provider, psychologist, psychiatrist, or other particularly
trained in special needs of a woman with PPD.
• Assess patient's perception of cause of sleep difficulty and
possible relief measures to facilitate treatment.
• Determine presence of physical or psycholigical stressors.
 POSTPARTUM DEPRESSION
MEDICAL
MANAGEMENT
• ANTIDEPRESANT THERAPY
Paroxetine (Paxil), fluoxetine (Prozac), and
sertraline (Zoloft) are selective serotonin
reuptake inhibitors (SSRIs).

• COUNSELING
POSTPARTUM

O V E R V I E W
BLUES
Postpartum "blues" is defined as
low mood and mild depressive
symptoms caused by the sudden
change in hormones after
delivery, combined with stress,
isolation, sleep deprivation, and
fatigue.
 POSTPARTUM BLUES
PATHOPHYSIOLOGY
After delivery of the placenta, mothers
experience an abrupt decline of
gonadal hormones, namely oestrogen
and progesterone.
 POSTPARTUM BLUES
CLINICAL
MANIFESTATION
Mood swings
Anxiety
Sadness
Irritability
Crying
Reduced concentration
Appetite problems
Insomnia
NURSING

POSTPARTUM BLUES
DIAGNOSIS
1. Cognitive impairement related to inability to cope up with
daily living as evidenced by disturbed concentration.

2. Disturbed sleep patterns related to trouble sleeping.

3. Imbalanced nutrition: Less than body requirements

related to lack of appetite.
GENERAL NURSING

POSTPARTUM BLUES
INTERVENTION
Provide companionship during mealtime.
Encourage daytime physical activities.
Encourage patient to take a milk.
Establish daily orientation.
Advice patient to have enough rest.
MEDICAL

POSTPARTUM BLUES
MANAGEMENT
Patients should still be carefully screened for suicidal
ideation, paranoia, or homicidal ideation towards the
infant.

Assistance with self and infant care, family support,

peer support, rest, and healthy nutrition usually
enables mothers to recover from postpartum blues.
 POSTPARTUM

OVERVIEW
PYSCHOSIS
Postpartum, or puerperal, psychosis (PP) is a
severe psychiatric disorder which typically
manifests within days of childbirth in a small
proportion of women (1-2 in every 1000 new
mothers).

The main symptoms of PP include

hallucinations and delusions, cognitive
disorganisation and confusion, anxiety and
sleep problems
 POSTPARTUM PSYCHOSIS
PATHOPHYSIOLOGY
Pathophysiological mechanisms underlying risk
for the condition are extremely poorly-defined,
but may include perturbed immune function,
altered tryptophan metabolism and serotonergic
dysfunction.
 POSTPARTUM PSYCHOSIS
CLINICAL
MANIFESTATION
Postpartum psychosis can come within a couple of weeks
after you give birth.

• Delusions
• Hallucinations
• Severe insomnia
• Feeling disconnected from your baby
• Constant mood swings
 POSTPARTUM PSYCHOSIS
NURSING
DIAGNOSIS
• Disturbed thought processes related top sychological
and cognitive disturbances as manifested by limited
attention span ,hallucination ,and laughing and talking to
himself without any reason.
• Risk for injury
• Impaired social interaction related to hallucinations.
 POSTPARTUM PSYCHOSIS
NURSING
INTERVENTION
Immediate care and treatment for both mother and
baby are vital and should be treated as an emergency
due to a number of factors such as the risk to them
both, the seriousness of the illness, the importance of
preventing further deterioration, and the increased
biological, psychological, and social needs of the
mother.
MEDICAL

POSTPARTUM PSYCHOSIS
MANAGEMENT
No single ideal combination of medications exists. Each woman
is different and may respond better to antidepressants or
antianxiety medicines instead of or in combination with a drug.

2 MEDICATIONS
Antipsychotics: These medications reduce the incidence of
hallucinations.
Mood stabilizers: These medications reduce manic episodes.
POSTPARTUM
HEMORRHAGE
Postpartum hemorrhage is heavy
bleeding after the birth of your baby.
Losing lots of blood quickly can cause a
severe drop in your blood pressure. It
may lead to shock and death if not
treated. The most common cause of
postpartum hemorrhage is when the
uterus does not contract enough after
delivery.
 POSTPARTUM HEMORRHAGE
PATHOPHYSIOLOGY
Uterine atony, or diminished myometrial contractility,
accounts for 80% of postpartum hemorrhage.

The other major causes include abnormal placental

attachment or retained placental tissue, laceration of
tissues or blood vessels in the pelvis and genital tract,
and maternal coagulopathies.
 POSTPARTUM HEMORRHAGE
CLINICAL
MANIFESTATION
• Uncontrolled bleeding.
• Decreased blood pressure.
• Increased heart rate.
• Decrease in the red blood cell count.
• Swelling and pain in the vagina and nearby area if
bleeding is from a hematoma.
NURSING
DIAGNOSIS
1.Risk for altered parent-infant attachment related to
inability of parents to meet personal needs.
2.Dificient fluid volume (isonotic) related to excessive
blood loss after birth.
3.Anxiety Related to situational/maturational crisis
GENERAL NURSING
INTERVENTION
• Save all perineal pads used during bleeding and weigh them
to determine the amount of blood loss.
• Place the woman in a side lying position to make sure that no
blood is pooling underneath her.
• Assess lochia frequently to determine if the amount
discharged is still within the normal limits.
MEDICAL
MANAGEMENT
Oxytocin (Pitocin)
Misoprostol (Cytotec)
Methylergonovine maleate (Methergine)
Carboprost tromethamine (Hemabate)
Dinoprostone (Prostin E2).
POSTPARTUM VAGINAL DISCHARGE

LOCHIA
In the field of obstetrics,
lochia is the vaginal discharge
after giving birth, containing
blood, mucus, and uterine
tissue. Lochia discharge
typically continues for four
to six weeks after childbirth, a
time known as the
postpartum period or
puerperium
 POSTPARTUM VAGINAL DISCHARGE
Lochia rubra
Days 2-4

Stages
Color: Dark red

of Lochia serosa
Days 4 last about 2
weeks

Lochia Color: Pinkish brown

Lochia Alba
Days 2-6 weeks
postpartum
Color: Whitish
yellow
 Group 2
GARIANDO, DANIEL

SARABAN, RASHIMA

ESMAEL, RAMAIDHA

THANK YOU!