Prepared by: Princess O.

Namoc

Clinical manifestations during the 4. Mastitis

puerperium (6-week period after delivery)
generally reflect reversal of the physiologic
changes that occurred during pregnancy
(see table Normal Postpartum Changes).
These changes are temporary and should
not be confused with pathologic conditions.
Serious postpartum complications are rare.
The most common complications are:
Mastitis is painful inflammation of the
breast, usually accompanied by infection.
5. Postpartum depression
Postpartum depression is depressive
symptoms that last > 2 weeks after delivery
and meet criteria for major depression.

1. Postpartum hemorrhage

Postpartum hemorrhage is blood loss

of > 1000 mL or blood loss accompanied by
symptoms or signs of hypovolemia within 24
hours of birth. Diagnosis is clinical.
Treatment depends on etiology of the
hemorrhage.

2. Postpartum endometritis

Postpartum endometritis is uterine infection,

typically caused by bacteria ascending from
the lower genital or gastrointestinal tract.
Symptoms are uterine tenderness,
abdominal or pelvic pain, fever, malaise,
and sometimes discharge. Diagnosis is
clinical, rarely aided by culture. Treatment is
with broad-spectrum antibiotics
(eg, clindamycin plus gentamicin).

3. Urinary tract infections (cystitis

and pyelonephritis)

Pyelonephritis may occur postpartum if

bacteria ascend from the bladder. The
infection may begin as asymptomatic
bacteriuria during pregnancy and is
sometimes associated with bladder
catheterization to relieve urinary distention
during or after labor. The causative
organism is usually a type of coliform
bacteria (eg, Escherichia coli).