Post Natal Follow-up

Presented By:
Hassan Haider (F19-005)
Postnatal follow-up:

 Post-natal management depends on antenatal and intra-natal conditions

 Normal Pregnancy
 Complicated Pregnancy
 1. Normal pregnancy
o Vitals monitoring
o Discharged within 6 hours of uncomplicated Birth
o Mid-wife visits for 10-days in high Risk patients
o 1-2 routine mid-wifey visits in first 10-days in low-risk women

 Counselling
Counsel the mother regarding her
o Her Health
o Baby’s Health
o Importance of Breastfeeding
o Vaccination of Baby
 At each visit ask about their recovery including
1. Bowel habits
2. Bladder function
3. Fatigue
4. Headache
5. Provide information about danger signs.
 Advantages of Breastfeeding
1- Readily available
2- Ideal nutrition value
3- Cheaper than formula milk
4- Contraceptive effect with amenorrhea
5- In Longer term, it is associated with
 Reduce childhood infective illnesses, gastroenteritis
 Reduce atopic illnesses e.g. eczema & asthma
 Reduce Juvenile diabetes
 Reduce likelihood of childhood cancer
 Reduce premenopausal breast cancer
Vaccination of mother

 Anti - rhesus D immunoglobulin should be given with in 72 hours of delivery in

all rhesus D negative mothers of rhesus D positive babies
 Mothers should offer rubella immunization.
Examination and routine test

 The only routine test to be performed at every postnatal visit in first week in forst week is
maternal blood pressure.
 Other examination depends upon maternal condition and symptoms.

Symptoms 3xamination

Offensive vaginal loss, sign of Pulse, temperature, assessment of

infection uterine involution

PPH, abnormal vaginal bleeding Assessment of uterine involution,

pulse, blood pressure,

Antenatal anemia, complicated Hemoglobin level, iron

delivery, PPH
 Anemia
 Hb level is checked on day 1—3
 > 7g/dl iron supplements either I/V or oral
 < 7g/dl – Transfusions

 Diabetes
 Within 6 weeks – OGTT
 If missed, with or after 3 months – HbA1c
 At 2 weeks postnatally, ask specifically
asked about the resoultion of the baby blues.

 Complicated pregnancy
 In case of complicated pregnancy, formal
postnatal examination should be done at 6
weeks.
 Assess physical and mental health of female
 Ask about progress of baby.
 Ask question about urinary, bowel, sexual
functions.
 Weight, urine analysis and blood
pressure should be checked
 Cervical smear: It should be preferable to take one after 3
months postpartum.
 Contraception, pelvic floor exercises, infant
immunization should also be discussed