Monitoring after delivery includes checking the mother for bladder or bowel incontinence. It includes further checking how breast feeding is going, whether any blood clots or infections develop. Apart from that the baby needs monitoring for lethargy , jaundice and proper weight gain.
Most women with a normal delivery stay in the hospital or a birthing center for 1 or 2 days. First-time mothers are recommended to stay 2 days rather than 1. Patients recovering from a caesarian section stay 3 to 4 days. More than 80% of patients in one study had at least one symptom or problems of the following: headaches, infections, incontinence (from pelvic floor descend), painful perineum or breast feeding (Ref. 18, p. 694).
About 3% in that study needed to go back into the hospital because of abnormal bleeding, more serious infections or symptoms of blood clots. All of this can be managed clinically, but the physician and the patient have to be certain that any problems are communicated. If in doubt, go to the hospital to be checked out!
A missed blood clot could develop into a serious condition where the patient runs out of clotting factors or the clot gets dislodged and leads to severe breathing problems due to pulmonary emboli and possible shock as a result of this.
As Semmelweiss described in 1861 in his book (Ref. 21), there is the constant danger of infections from non sterile techniques during child birth.
In addition, there is always a possibility of infections from intravaginal, cervical and perineal lacerations due to childbirth where the bacteria naturally present in the area can enter into the tissues or blood stream. Luckily we do have powerful antibiotics available in our time that help the physician to combat infections where needed.
Monitoring After Delivery (Jaundiced Baby In Hospital Under Lights)
Apart from the mother, the baby has to be monitored. Alarm signs to watch for are fever, lethargy, change in feeding habits, vomiting, diarrhea, jaundice. Regular visits with the treating physician are important to check on the weight of the baby, monitor the growth rate and to give childhood vaccinations on a regular basis.
References
1. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 235.
2. B. Sears: “Zone perfect meals in minutes”. Regan Books, Harper Collins, 1997.
3. Ryan: Kistner’s Gynecology & Women’s Health, 7th ed.,1999 Mosby, Inc.
4. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 245.
5. AB Diekman et al. Am J Reprod Immunol 2000 Mar; 43(3): 134-143.
6. V Damianova et al. Akush Ginekol (Sofia) 1999; 38(2): 31-33.
7. Townsend: Sabiston Textbook of Surgery,16th ed.,2001, W. B. Saunders Company
8. Cotran: Robbins Pathologic Basis of Disease, 6th ed., 1999 W. B. Saunders Company
9. Rakel: Conn’s Current Therapy 2001, 53rd ed., W. B. Saunders Co.
10. Ruddy: Kelley’s Textbook of Rheumatology, 6th ed.,2001 W. B. Saunders Company
11. EC Janowsky et al. N Engl J Med Mar-2000; 342(11): 781-790.
12. Wilson: Williams Textbook of Endocrinology, 9th ed.,1998 W. B. Saunders Company
13. KS Pena et al. Am Fam Physician 2001; 63(9): 1763-1770.
14. LM Apantaku Am Fam Physician Aug 2000; 62(3): 596-602.
15. Noble: Textbook of Primary Care Medicine, 3rd ed., 2001 Mosby, Inc.
16. Goroll: Primary Care Medicine, 4th ed.,2000 Lippincott Williams & Wilkins
17. St. Paul’s Hosp. Contin. Educ. Conf. Nov. 2001,Vancouver/BC
18. Gabbe: Obstetrics – Normal and Problem Pregnancies, 3rd ed., 1996 Churchill Livingstone, Inc.
19. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 251.
20. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 250.
21. Ignaz P Semmelweiss: “Die Aetiologie, der Begriff und die Prophylaxis des Kindbettfiebers” (“Etiology, the Understanding and Prophylaxis of Childbed Fever”). Vienna (Austria), 1861.
22. Rosen: Emergency Medicine: Concepts and Clinical Practice, 4th ed., 1998 Mosby-Year Book, Inc.
23. Mandell: Principles and Practice of Infectious Diseases, 5th ed., 2000 Churchill Livingstone, Inc.
24. Horner NK et al. J Am Diet Assoc Nov-2000; 100(11): 1368-1380.
25. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.
26. Rakel: Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier
