Postpartum Disorders.

✨Postpartum disorders are unexpected events or occurrences that can happen during the postpartum period. 

✍️It is imperative for a nurse to have a thorough understanding of each disorder and initiate appropriate nursing interventions to achieve positive outcome.

Commonn postpartum disorders include:
📌Superficial &deep-vein thrombosis.

📌Pulmonary embolus.

📌Coagulopathies(IPT,DIC).

📌Postpartum hemorrhage.

📌Atony, inversion, & subinvolution of the uterus.

📌Retained placenta.

📌Lacerations, & hematomas.

🔖Deep‑Vein Thrombosis

-Thrombophlebitis refers to a thrombus that is associated with inflammation

-Thrombophlebitis of the lower extremities can be of superficial or deep veins, which are most often of the femoral, saphenous, or popliteal veins. 

-The postpartum client is at greatest risk for a deep-vein thrombosis (DVT) that can lead to a pulmonary embolism

EXPECTED FINDINGS📜

a. Leg pain and tenderness.

b. Unilateral swelling, warmth, and redness.

c. Hardened vein over the thrombosis.

d. Calf tenderness.

🕹️Risk Factors

a. Cesarean birth (doubles the risk).

b. Operative vaginal birth.

c. Pulmonary embolism or varicosities.

d. Immobility.

e. Obesity.

f. Multiparity.

g. Age greater than 35 years.

Prevention of thrombophlebitis

✍️Maintain sequential compression device until ambulation established.
🕹️Prolonged bed rest  greater than 8 hr👉 use active and passive range of motion to promote circulation in the legs if warranted.
✍️Initiate early and frequent ambulation postpartum.
✍️Measure the lower extremities for fitted elastic thromboembolic hose to lower extremities.

Client Education.

✔️Avoid prolonged periods of standing, sitting, or immobility.
✔️Elevate both legs when sitting, refrain from extended periods of time in chairs and recliners.
✔️Avoid crossing the legs, which will reduce the circulation and exacerbate venous stasis.
✔️Maintain fluid intake of 2 to 3 L each day from food and beverage sources to prevent dehydration, which causes circulation to be sluggish.
✔️Discontinue smoking.

🔖Pulmonary Embolus

✨An embolus occurs when fragments or an entire clot dislodges and moves into circulation.

✨A pulmonary embolism is a complication of DVT that occurs if the embolus moves into the pulmonary artery or one of its branches and lodges in a lung, occluding the vessel and obstructing blood flow to the lungs. Acute pulmonary embolus is an emergent situation

Expected Findings.

a. Chest pain

b. Dyspnea

c. Tachypnea

d. Tachycardia

e. Syncope

f. Crackles with breath sounds

g. Elevated temperature

h. Hypoxia

Note: Risk factors for PE are similar to those of DVT.

Uterine Atony

▶Uterine atony results from the inability of the uterine muscle to contract adequately after birth. This can lead to postpartum hemorrhage.

RISK FACTORS

▶Retained placental tissues.

▶Prolonged or precipitous labor.

▶Oxytocin induction or augmentation of labor.

▶Overdistention of the uterine muscle (multiparity, multiple gestations, polyhydramnios, macrosomic fetus).

▶Magnesium sulfate therapy during labor.

▶Anesthesia and analgesia administration during labor.

▶Trauma during labor and birth from operative delivery (forceps- or vacuum-assisted birth, cesarean birth).