China
Africa
Explore chapters and articles related to this topic
Antiseptics, antibiotics and chemotherapy
Published in Michael J. O’Dowd, The History of Medications for Women, 2020
François Mauriceau (1686) in his The Diseases of Women with Child mote that ‘Very often the stopping of the lochia, (of which we have lately discoursed, and especially at the beginning of Child-bed) doth cause an Inflammation to the Womb, which is a very dangerous Disease, and the death of most of the Women to whom it happens’. Mauriceau gave a graphic description of the symptoms and signs and related that ‘If she do not the of it, an Abscess will be made there ... which will make her lead a miserable life the rest of her days’. His approach was to use a cooling diet, herbal medications, venesection and detersive (cleansing) injections to carry off the corrupt matter and retained lochia.
The context of birth
Published in Helen Baston, Midwifery, 2020
The blood loss following childbirth is called lochia and changes over time. For about the first three days the red loss contains blood and decidua from the placental site. The volume reduces and becomes pink or brown in colour containing decidua and epithelial cells from the vagina as well as leucocytes and mucus. Some white/yellow discharge may persist for up to six weeks which contains leucocytes, cervical mucous and serous fluid. Lochia should not contain blood clots or smell offensive; both are signs of a potential infection.
The Reproductive System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
The process of giving birth is called parturition. This includes labor, which is divided into four stages, and delivery, the passage of the fetus and placenta from the genital canal into the external world. Terms associated with the birth process refer to presentation of the fetus (breech, vertex, transverse, face, cephalic, depending on which fetal structure faces the cervix) or to procedures involved (episiotomy, hysterotomy, Cesarean section). Immediately after delivery of the fetus, the secundines or "afterbirth," which includes the placenta and attached umbilical cord, are expelled as the final stage of labor. Lochia refers to the discharge of mucus, blood, and tissue debris that continues for a period of time following childbirth.
Leptrotrichia Amnionii, an emerging pathogen of postpartum endometritis
Published in Acta Clinica Belgica, 2018
Tine Masschaele, Sophia Steyaert, Ronny Goethals
Postpartum endometritis is a common cause of postpartum febrile morbidity. The United Joint Commission on Maternal Welfare defines postpartum febrile morbidity as an oral temperature of ≥38.0 °C on any 2 of the first 10 days postpartum, exclusive of the first 24 h [1]. The first 24 h are excluded because low grade fever during this period is common and often resolves spontaneously, especially after vaginal birth [2]. Postpartum fever, tachycardia, midline lower abdominal pain and uterine tenderness are the key clinical findings. Purulent lochia, chills, headache, malaise, and/or anorexia are additional findings occasionally observed [3]. Differential diagnosis should be made with episiotomy incision infection, mastitis, pyelonephritis, appendicitis, viral syndrome. Usual etiologies for postpartum endometritis include Enterobacteriaceae, Streptococcus pyogenes, Streptococcus agalactiae, mixed anaerobic genera, Mycoplasma genitalium and Chlamydia trachomatis.
Mast cell activation syndrome in pregnancy, delivery, postpartum and lactation: a narrative review
Published in Journal of Obstetrics and Gynaecology, 2020
Shanda R. Dorff, Lawrence B. Afrin
Both providers and patients would like to have MCAS symptoms arising during pregnancy cease upon delivery, but that is often not the case. There is further physical and psychological stress during recovery from pregnancy and delivery as well as adjustment to having a neonate, including attendant hormonal changes. Again, some of the fundamental pathobiological behaviours of MCAS stem from the MC’s normal acute and chronic responses to stress, including degranulation with release of a cornucopia of pro-inflammatory mediators. The post-partum time period is generally defined as immediately following delivery through the first 6–8 weeks or longer. MCAS patients in theory could be at higher risk for post-partum haemorrhage with or without prolonged post-partum rubra lochia from endogenous heparin release from MCs or enhanced fibrinolysis driven by activated MCs (Seidel et al. 2011). Incidence of ‘baby blues’, post-partum depression, and post-partum anxiety also could be increased in the post-partum MCAS population, as psychiatric comorbidities often wax during flares of MCAS (Afrin et al. 2015). When genitourinary tract MCs are overactive, inflammation may be stoked in segments, or the entirety, of the genitourinary tract and may result in vaginitis, incontinence, dyspareunia, endometritis, dysuria with or without interstitial cystitis, dysfunctional uterine bleeding, cervicitis, and more (Afrin et al. 2019). Table 4 lists further potential complications. Medications may be more difficult to tolerate when the patient is more inflamed, too. It is important to investigate potential excipient issues if an MCAS patient adversely reacts to a medication product being newly tried, particularly if the drug in the product is ordinarily a well-tolerated drug.
Bowel on the bowl: a case report of spontaneous post-partum vaginal evisceration of small bowel
Published in Journal of Obstetrics and Gynaecology, 2018
Joanne Hui Yee Lim, Jessica Hui Cheah Lim, Grace Hui Chin Lim, Bryan Lim, Maha Alkatib
On day 2 following delivery, the patient activated the emergency buzzer after finding a mass protruding between her legs whilst opening her bowels. She was sitting on the toilet bowl distressed and holding onto prolapsed loops of bowel with tissue paper. Vaginal examination revealed approximately 40 cm of erythematous small bowel without vascular compromise. A large sterile gauze swab soaked with warmed normal saline was used to wrap around the bowel loops. Intravenous fluids and broad-spectrum antibiotics (cefuroxime 1.5 g and metronidazole 500 mg) were given pre-operatively. She was anaesthetised by rapid sequence induction and placed in the lithotomy position. Attempts were made to reduce the small bowel loops vaginally but this approach was unsuccessful due to a lack of adequate access because the tear was high in the posterior vaginal wall. Decision was made to proceed with laparotomy. She was placed in Trendelenburg position and a midline laparotomy was performed. The small bowel loops which eviscerated was noted to be about 1 m away from the ileocaecal valve. Carefully, the eviscerated bowel was gently replaced into the abdomen through the vaginal defect. The bowel was inspected thoroughly through its entire length to exclude any damage. Apart from looking slightly congested, there was a small amount of tissue paper adhering to some parts of the bowel. Lugol’s iodine solution was used to remove the tissue paper particles from the bowel. A 4 cm defect was noted in the Pouch of Douglas and this was repaired using absorbable 2–0 vicryl suture. Peritoneal lavage using 1 L of warmed normal saline was done to reduce risk of infection. Her intra-operative Haemoglobin was 80 g/L and she was given 2 units of blood transfusion. The broad-spectrum antibiotics were continued for a total of five days. When further explored, the patient admitted that her lochia had been heavy after the delivery but she thought this was normal after childbirth.