PAEA OBGYN EOR TOPICS
is diagnosed clinically in postpartum patients with 2 fevers
and uterine tenderness and is mostly seen s/p *c-section* but can also
be present s/p vaginal delivery or postabortus - ANSWERS-
postpartum endometritis (polymicrobial infection of the endometrium
d/t exposure during childbirth)
what is the ddx/tx for postpartum endometritis? - ANSWERS--ddx:
surgical site infxn, UTI, mastitis, PNA
-tx: broad spectrum abx (*clindamycin + gentamicin* OR ampicillin-
sulbactam in clinda resistance or if GBS (+)); add ampicillin or
vancomycin if fever doesn't resolve in 48-72 hrs
-*ampicillin + gentamicin* if after vaginal delivery
*diagnosis made clinically from 2 fevers and uterine tenderness (other
sx's include foul lochia, chills, lower abdominal pain)
what are the differences b/t 1st-4th degree lacerations postpartum? -
ANSWERS--1st deg: skin/mucosa only
-2nd deg: extend into perineal body but do not involve anal sphincter
-3rd deg: extend into or completely through anal sphincter
-4th deg: through anal mucosa (may be a button hole laceration so
perform rectal exam)
