Recommendations during the puerperium
Complications during early postpartum (up to 10 days postpartum) and late postpartum (up to 45 days postpartum)
- Bleeding. It can be caused by uterine atony or by the loss of blood from the vessels of the cervix, vagina or vulva.
- Urine infection. Physiological changes in pregnancy and recurrent bladder catheterization (emptying of the bladder with a urine tube) during labor, especially in women who have had a long birth and with peridural anesthesia, may favor infections. urine during the postpartum period. Pain when urinating, an increase in the frequency of urination, and a feeling of emptying the bladder are indirect symptoms of a urinary tract infection; culture will be needed to confirm their diagnosis and prescribe antibiotic treatment.
- Thromboembolism. During pregnancy and the postpartum period, there are physiological changes that can promote the onset of thrombosis, especially in obese women or who have had a cesarean section. Pain, redness, and swelling of a vessel in your legs or an increase in body temperature may be a signal of the appearance of thrombi. To prevent this problem it is necessary for the woman to move and wander and avoid compressing her legs during labor. In some cases, the administration of prophylactic heparin will be indicated.
- Puerperal infection. An increase in body temperature above 38 ° C for 48 hours during the first 15 days of postpartum may be a sign of a puerperal infection. The infection, usually caused by a microorganism, is located in the genital tract and can spread to other systems such as the urinary tract, breasts, or respiratory system. The fever it is accompanied by an increase in heart rate, malaise, fatigue, painful and soft uterus, and fetid lachiosis (smelly vaginal losses).
- Fetish fetishes. The hematic losses that begin after delivery are called loquis and change in appearance as the puerperium progresses: first they are abundant and red, then scarce and clear. Fetal leukocytes may indicate a puerperal infection or the presence of material in the vagina, such as gauze used during labor.
- Mastitis. It is the inflammation of the breast tissue. It usually occurs in one breast and may be caused by the onset of cracks on the nipple, which are the gateway for microorganisms (infectious mastitis) or that cause milk stasis (non-infectious mastitis). Pain, redness, and induration of the entire chest or in an area of the chest usually presents with fever, which can reach 40 degrees Celsius. To treat mastitis, the baby must empty the mother's breast; you need to look at it when it touches your chest to see if it is emptying enough. If not, one will have to be made emptying manual or with strips. Depending on the type of mastitis, antibiotic treatment will need to be performed. The most extreme form of the mastitis is breast abscess, which is very painful and requires surgical treatment.
- Postpartum depression. Childbirth involves a physical and emotional readjustment that is experienced during the postpartum period. In the early days, there is usually a tendency for sadness, which is overcome as the woman becomes acquainted with the baby's caring skills and becomes aware of it. Postpartum sadness can turn into depression if the mother is not able to adapt to the new situation. Sleep disorders, loss of appetite and excitement, loss of control, and inability to concentrate are some of the symptoms of postpartum depression. In any case, the child should have the emotional support of the couple, family, friends and professionals.
'Complications during the early and late postpartum period', d'Virtual Nurse, content under license CC BY-NC-ND 3.0 ES, with modifications made by the Gynecology and Obstetrics Service of the Hospital de Sabadell