Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-5f56664f6-2gss9 Total loading time: 0 Render date: 2025-05-07T18:24:43.965Z Has data issue: false hasContentIssue false

Section 7 - Postpartum

Published online by Cambridge University Press:  08 April 2025

Edited by
Peter F. Schnatz ,
D. Yvette LaCoursiere ,
Christopher M. Morosky ,
Jonathan Schaffir ,
Vanessa Torbenson  and
David Chelmow
Peter F. Schnatz
Affiliation:
The Reading Hospital, Pennsylvania
D. Yvette LaCoursiere
Affiliation:
University of California, San Diego
Christopher M. Morosky
Affiliation:
University of Connecticut School of Medicine
Jonathan Schaffir
Affiliation:
The Ohio State University College of Medicine
Vanessa Torbenson
Affiliation:
Mayo Clinic Alix School of Medicine
David Chelmow
Affiliation:
Virginia Commonwealth School of Medicine
Get access
Type
Chapter
Information
Pregnancy Complications
A Case-Based Approach
 , pp. 193 - 228
Publisher: Cambridge University Press
Print publication year: 2025

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Book purchase

Temporarily unavailable

References

References

Committee on Practice Bulletins-Obstetrics. Practice Bulletin No. 183: Postpartum Hemorrhage. Obstet Gynecol. 2017;130:e168–e186.CrossRefGoogle Scholar
Quantitative Blood Loss in Obstetric Hemorrhage: ACOG Committee Opinion, Number 794. Obstet Gynecol. 2019;134:e150–156.CrossRefGoogle Scholar
Ende, HB, Lozada, MJ, Chestnut, DH, et al. Risk Factors for Atonic Postpartum Hemorrhage: A Systematic Review and Meta-analysis. Obstet Gynecol. 2021;137:305–323.CrossRefGoogle ScholarPubMed
Begley, CM, Gyte, GM, Devane, D, et al. Active versus Expectant Management for Women in the Third Stage of Labour. Cochrane Database Syst Rev. 2019;(2):CD007412.CrossRefGoogle Scholar
Alliance for Innovation on Maternal Health. Obstetric Hemorrhage Patient Safety Bundle. https://saferbirth.org/wp-content/uploads/U2-FINAL_AIM_Bundle_ObstetricHemorrhage.pdf (accessed June 10, 2023).Google Scholar
WOMAN Trial Collaborators. Effect of Early Tranexamic Acid Administration on Mortality, Hysterectomy, and Other Morbidities in Women with Post-partum Haemorrhage (WOMAN): An International, Randomised, Double-Blind, Placebo Controlled Trial. Lancet. 2017;389:2105–2116.Google Scholar
Zwart, JJ, Dijk, PD, van Roosmalen, J. Peripartum Hysterectomy and Arterial Embolization for Major Obstetric Hemorrhage: A 2-Year Nationwide Cohort Study in the Netherlands. Am J Obstet Gynecol. 2010;202:150.e1–150.e7.Google ScholarPubMed
Hayman, RG, Arulkumaran, S, Steer, PJ. Uterine Compression Sutures: Surgical Management of Postpartum Hemorrhage. Obstet Gynecol. 2002;99:502–506.Google ScholarPubMed
B-Lynch, C, Coker, A, Lawal, AH, Abu, J. Cowen, MJ. The B-Lynch Surgical Technique for the Control of Massive Postpartum Hemorrhage: An Alternative to Hysterectomy? Five Cases Reported. Br J Obstet Gynaecol. 1997;104:372–375.CrossRefGoogle ScholarPubMed

References

Taylor, M, Jenkins, SM, Pillarisetty, LS. Endometritis. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2023. www.ncbi.nlm.nih.gov/books/NBK553124/ (accessed October 15, 2024).Google Scholar
Burrows, LJ, Meyn, LA, Weber, AM. Maternal Morbidity Associated with Vaginal versus Cesarean Delivery. Obstet Gynecol. 2004;103(5 Pt. 1):907–912.CrossRefGoogle ScholarPubMed
Smaill, FM, Grivell, RM. Antibiotic Prophylaxis versus No Prophylaxis for Preventing Infection after Cesarean Section. Cochrane Database Syst Rev. 2014;(10):CD007482.CrossRefGoogle Scholar
Meaney-Delman, D, Bartlett, LA, Gravett, MG, Jamieson, DJ. Oral and Intramuscular Treatment Options for Early Postpartum Endometritis In Low-Resource Settings: A Systematic Review. Obstet Gynecol. 2015;125(4):789–800.CrossRefGoogle ScholarPubMed
Mackeen, AD, Packard, RE, Ota, E, Speer, L. Antibiotic Regimens for Postpartum Endometritis. Cochrane Database Syst Rev. 2015;(2):CD001067.CrossRefGoogle Scholar
DeNoble, AE, Kuller, JA, Heine, RP, Dotters-Katz, S. Antibiotics for the Prevention and Treatment of Postsurgical Obstetric Infections. Obstet Gynecol Surv. 2018;73(8):475–485.CrossRefGoogle ScholarPubMed
Society for Maternal-Fetal Medicine (SMFM); Plante, LA, Pacheco, LD, Louis, JM. SMFM Consult Series #47: Sepsis during Pregnancy and the Puerperium. Am J Obstet Gynecol. 2019;220(4):B2–B10. Erratum in: Am J Obstet Gynecol. 2021;224(2):224.CrossRefGoogle Scholar
Deguchi, Y, Horiuchi, Y, Shojima, K, et al. Postpartum Methicillin-Resistant Staphylococcus aureus Toxic Shock Syndrome Caused by a Perineal Infection. Case Rep Obstet Gynecol. 2018; 2018:2670179.Google ScholarPubMed
Harris, K, Proctor, LK, Shinar, S, et al. Outcomes and Management of Pregnancy and Puerperal Group A Streptococcal Infections: A Systematic Review. Acta Obstet Gynecol Scand. 2023;102(2):138.CrossRefGoogle ScholarPubMed
Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 199: Use of Prophylactic Antibiotics in Labor and Delivery. Obstet Gynecol. 2018;132:e103–e119.CrossRefGoogle Scholar

References

American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins–Obstetrics. ACOG Practice Bulletin No. 197: Inherited Thrombophilias in Pregnancy. Obstet Gynecol. 2018;132:e18–e34.Google Scholar
American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins–Obstetrics. ACOG Practice Bulletin No. 196: Thromboembolism in Pregnancy. Obstet Gynecol. 2018;132:e1–e17.CrossRefGoogle Scholar
Bain, E, Wilson, A, Tooher, R, et al. Prophylaxis for Venous Thromboembolic Disease in Pregnancy and the Early Postnatal Period. Cochrane Database Syst Rev. 2014;(2):CD001689.CrossRefGoogle Scholar
Leung, AN, Bull, TM, Jaeschke, R, et al.; ATS/STR Committee on Pulmonary Embolism in Pregnancy. An Official American Thoracic Society/Society of Thoracic Radiology Clinical Practice Guideline: Evaluation of Suspected Pulmonary Embolism in Pregnancy. Am J Respir Crit Care Med. 2011;184(10):1200–1208.Google ScholarPubMed
Leffert, L, Butwick, A, Carvalho, B, et al.; the Members of the SOAP VTE Taskforce. The Society for Obstetric Anesthesia and Perinatology Consensus Statement on the Anesthetic Management of Pregnant and Postpartum Women Receiving Thromboprophylaxis or Higher Dose Anticoagulants. Anesth Analg. 2018;126(3):928–944.CrossRefGoogle ScholarPubMed

References

Hutner, LA, Yeaton-Massey, A, Toscano, M, et al. Cultivating Mental Health Education in Obstetrics and Gynecology: A Call to Action. Am J Obstet Gynecol MFM. 2021;3:100459.Google Scholar
Wisner, KL, Sit, DKY, McShea, MC, et al. Onset Timing, Thoughts of Self-harm, and Diagnoses in Postpartum Women with Screen-Positive Depression Findings. JAMA Psychiatry. 2013;70:490–498.CrossRefGoogle ScholarPubMed
Fawcett, EJ, Fairbrother, N, Cox, ML, White, IR, Fawcett, JM. The Prevalence of Anxiety Disorders during Pregnancy and the Postpartum Period: A Multivariate Bayesian Meta-analysis. J Clin Psychiatry. 2019;80:18r12527.CrossRefGoogle ScholarPubMed
Masters, GA, Hugunin, J, Xu, L, et al. Prevalence of Bipolar Disorder in Perinatal Women: A Systematic Review and Meta-analysis. J Clin Psychiatry. 2022;83:21r14045.Google ScholarPubMed
Screening and Diagnosis of Mental Health Conditions during Pregnancy and Postpartum: ACOG Clinical Practice Guideline No. 4. Obstet Gynecol. 2023;141:1232–1261.Google Scholar
McKee, K, Admon, LK, Winkelman, TNA, et al. Perinatal Mood and Anxiety Disorders, Serious Mental Illness, and Delivery-Related Health Outcomes, United States, 2006–2015. BMC Womens Health. 2020;20:150–156.Google ScholarPubMed
Jahan, N, Went, TR, Sultan, W, et al. Untreated Depression during Pregnancy and Its Effect on Pregnancy Outcomes: A Systematic Review. Cureus. 2021;13:e17251.Google ScholarPubMed
Trost, SL, Beauregard, JL, Smoots, AN, et al. Preventing Pregnancy-Related Mental Health Deaths: Insights from 14 US Maternal Mortality Review Committees, 2008–17. Health Aff. 2021;40:1551–1559.Google ScholarPubMed
Trost, S, Beauregard, J, Chandra, G, et al. Pregnancy-related deaths: data from maternal mortality review committees in 36 US states, 2017–2019. www.cdc.gov/maternal-mortality/php/data-research/mmrc-2017-2019.html (accessed October 21, 2024).Google Scholar
Treatment and Management of Mental Health Conditions during Pregnancy and Postpartum: ACOG Clinical Practice Guideline No.5. Obstet Gynecol. 2023;141:1262–1288.Google Scholar

References

Bauersachs, J, König, T, Van der Meer, P, et al. Pathophysiology, Diagnosis and Management of Peripartum Cardiomyopathy: A Position Statement from the Heart Failure Association of the European Society of Cardiology Study Group on Peripartum Cardiomyopathy. Eur J Heart Fail. 2019;21:827–843.CrossRefGoogle Scholar
Sliwa, K, Mebazaa, A, Hilfiker-Kleiner, D, et al. Clinical Characteristics of Patients from the Worldwide Registry on Peripartum Cardiomyopathy (PPCM): EURObservational Research Programme in Conjunction with the Heart Failure Association of the European Society of Cardiology Study Group on PPCM. Eur J Heart Fail. 2017;19:1131–1141.CrossRefGoogle Scholar
Arany, Z, Elkayam, U. Peripartum Cardiomyopathy. Circulation. 2016;133:1397–1409.CrossRefGoogle ScholarPubMed
Davis, MB, Arany, Z, McNamara, DM, et al. Peripartum Cardiomyopathy: JACC State-of-the Art Review. J Am Coll Cardiol. 2020;75:207–221.CrossRefGoogle ScholarPubMed
Regitz-Zagrosek, V, Roos-Hesselink, JW, Bauersachs, J, et al. 2018 ESC Guidelines for the Management of Cardiovascular Diseases during Pregnancy. Eur Heart J. 2018;39:3165–3241.CrossRefGoogle ScholarPubMed
Elkayam, U. Clinical Characteristics of Peripartum Cardiomyopathy in the United States: Diagnosis, Prognosis, and Management. J Am Coll Cardiol. 2011;58:659–670.Google Scholar
McNamara, DM, Elkayam, U, Alharethi, R, et al. Clinical Outcomes for Peripartum Cardiomyopathy in North America: Results of the IPAC Study (Investigations of Pregnancy-Associated Cardiomyopathy). J Am Coll Cardiol. 2015;66:905–914.Google ScholarPubMed

References

American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 209: Obstetric Analgesia and Anesthesia. Obstet Gynecol. 2019;133:e208–e225.Google Scholar
Buddeberg, BS, Bandschapp, O, Girard, T. Post-dural Puncture Headache. Minerva Anesthesiol. 2019;85:543–553.Google ScholarPubMed
Basurto Ona, X, Osorio, D, Bonfill Cosp, X. Drug Therapy for Treating Post-dural Puncture Headache. Cochrane Database Syst Rev. 2015;(7):CD007887.CrossRefGoogle Scholar
Vallejo, MC, Zakowski, MI. Post-dural Puncture Headache Diagnosis and Management. Best Pract Res Clin Anaesthesiol. 2022;36(1):179–189.CrossRefGoogle ScholarPubMed
Banks, S, Paech, M, Gurrin, L. An Audit of Epidural Blood Patch after Accidental Dural Puncture with a Tuohy Needle in Obstetric Patients. Int J Obstet Anesth. 2001;10:172.Google ScholarPubMed
Kawaguchi, M, Hashizume, K, Watanabe, K, et al. Fluoroscopically Guided Epidural Blood Patch in Patients with Postdural Puncture Headaches after Spinal and Epidural Anesthesia. J Anesth. 2011;25:450.CrossRefGoogle ScholarPubMed

References

Clark, SL. Amniotic Fluid Embolism. Obstet Gynecol. 2014;123:337–348.Google ScholarPubMed
Sultan, P, Seligman, K, Carvalho, B. Amniotic Fluid Embolism: Update and Review. Curr Opin Anaesthesiol. 2016;29(3):288–296.Google ScholarPubMed
Conde-Agudelo, A, Romero, R. Amniotic Fluid Embolism: An Evidence-Based Review. Am J Obstet Gynecol. 2009;201(5):445.e1–445.e13.Google ScholarPubMed
Shamshirsaz, AA, Clark, SL. Amniotic Fluid Embolism. Obstet Gynecol Clin North Am. 2016;43(4):779–790.CrossRefGoogle ScholarPubMed
Pacheco, LD, Saade, G, Hankins, GD, Clark, SL. Amniotic Fluid Embolism: Diagnosis and Management. Am J Obstet Gynecol. 2016;215(2):B16–B24.CrossRefGoogle ScholarPubMed
Long, M, Martin, J, Biggio, J. Atropine, Ondansetron, and Ketorolac: Supplemental Management of Amniotic Fluid Embolism. Ochsner J. 2022;22(3):253–257.CrossRefGoogle ScholarPubMed
Rezai, S, Hughes, AC, Larsen, TB, Fuller, PN, Henderson, CE. Atypical Amniotic Fluid Embolism Managed with a Novel Therapeutic Regimen. Case Rep Obstet Gynecol. 2017;2017:8458375.Google ScholarPubMed
Combs, CA, Montgomery, DM, Toner, LE, Dildy, GA. Society for Maternal-Fetal Medicine Special Statement: Checklist for Initial Management of Amniotic Fluid Embolism. Am J Obstet Gynecol. 2021;224(4):B29–B32.CrossRefGoogle Scholar
ACOG Committee Opinion No. 487: Preparing for Clinical Emergencies in Obstetrics and Gynecology. Obstet Gynecol. 2011;117(4):1032–1034.CrossRefGoogle Scholar

References

Wolman, I, Altman, E, Faith, G, et al. Combined Clinical and Ultrasonographic Work-up for the Diagnosis of Retained Products of Conception. Fertil Steril. 2009;92:1162.CrossRefGoogle ScholarPubMed
Kamaya, A, Petrovitch, I, Chen, B, et al. Retained Products of Conception: Spectrum of Color Doppler Findings. J Ultrasound Med. 2009;28:1031.CrossRefGoogle ScholarPubMed
Sellmyer, MA, Desser, TS, Maturen, KE, et al. Physiologic, Histologic, and Imaging Features of Retained Products of Conception. Radiographics. 2013;33:781.Google ScholarPubMed
Richards, EG, Rehmer, JM, Falcone, T. Perforation during Gynecological Procedures. JAMA. 2023;329(11):933–934.Google ScholarPubMed
American College of Obstetricians and Gynecologists. ACOG Practice Bulletin: Clinical Management Guidelines for Obstetrician-Gynecologists Number 76, October 2006: Postpartum Hemorrhage. Obstet Gynecol. 2006;108(4):1039–1047.Google Scholar
Fox, R, Aitken, G, Mooney, SS. Management of Secondary Postpartum Haemorrhage: A Systematic Review. Eur J Obstet Gynecol Reprod Biol. 2023;282:116–123.CrossRefGoogle ScholarPubMed
Ahonen, J, Stefanovic, V, Lassila, R. Management of Post-partum Haemorrhage. Acta Anaesthesiol Scand. 2010;54(10):1164–1178.Google ScholarPubMed
Lissauer, D, Wilson, A, Hewitt, CA, et al. A Randomized Trial of Prophylactic Antibiotics for Miscarriage Surgery. N Engl J Med. 2019;380(11):1012–1021.CrossRefGoogle ScholarPubMed
Low, N, Mueller, M, Van Vliet, HA, et al. Perioperative Antibiotics to Prevent Infection after First-Trimester Abortion. Cochrane Database Syst Rev. 2012;(3):CD005217.CrossRefGoogle Scholar

References

Chawla, JJ, Arora, D, Sandhu, N, Jain, M, Kumari, A. Pubic Symphysis Diastasis: A Case Series and Literature Review. Oman Med J. 2017;32(6):510–514.CrossRefGoogle ScholarPubMed
Herren, C, Sobottke, R, Dadgar, A, et al. Peripartum Pubic Symphysis Separation: Current Strategies in Diagnosis and Therapy and Presentation of Two Cases. Injury. 2015;46(6):1074–1080.CrossRefGoogle ScholarPubMed
Anastasio, MK, Anastasio, AT, Kuller, JA. Peripartum Pubic Symphysis Diastasis. Obstet Gynecol Surv. 2023;78(6):369–375.CrossRefGoogle ScholarPubMed
Seidman, AJ, Siccardi, MA. Postpartum Pubic Symphysis Diastasis. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2023. www.ncbi.nlm.nih.gov/books/NBK537043/ (accessed October 15, 2024).Google Scholar
Snow, RE, Neubert, AG. Peripartum Pubic Symphysis Separation. Obstet Gynecol Surv. 1997;52(7):438–443.CrossRefGoogle ScholarPubMed
Stolarczyk, A, Stępiński, P, Sasinowski, L, et al. Peripartum Pubic Symphysis Diastasis: Practical Guidelines. J Clin Med. 2021;10(11):2443.CrossRefGoogle ScholarPubMed
Howell, ER. Pregnancy-Related Symphysis Pubis Dysfunction Management and Postpartum Rehabilitation: Two Case Reports. J Can Chiropr Assoc. 2012;56(2):102–111.Google ScholarPubMed
Bickley, LS, Szilagyi, PG, Bates, B. Bates’ Guide to Physical Examination and History-taking, 13th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2021.Google Scholar
Palvia, V, Kim, S, Warholic, H, Anasti, J. Severe Pubic Symphysis Diastasis Managed Conservatively: A Case Report and Review. Case Rep Clin Med. 2017;6(4):120–126.Google Scholar
Khorashadi, L, Petscavage, JM, Richardson, ML. Postpartum Symphysis Pubis Diastasis. Radiol Case Rep. 2011;6(3):542.Google ScholarPubMed

References

World Health Organization. Mastitis: Causes and Management. Geneva: World Health Organization; 2000. https://apps.who.int/iris/handle/10665/66230 (accessed April 22, 2023).Google Scholar
Wilson, E, Woodd, SL, Benova, L. Incidence of and Risk Factors for Lactational Mastitis: A Systematic Review. J Hum Lact. 2020;36(4):673–686.Google ScholarPubMed
Lawrence, RA, Lawrence, RM. Breastfeeding: A Guide for the Medical Professional, 9th ed. New York: Elsevier; 2021.Google Scholar
Weaver, SR, Hernandez, LL. Autocrine-Paracrine Regulation of the Mammary Gland. J Dairy Sci. 2016;99:842–853.CrossRefGoogle ScholarPubMed
Mitchell, KB, Johnson, HM, Rodriguez, JM, et al. Academy of Breastfeeding Medicine Clinical Protocol #36: The Mastitis Spectrum, Revised 2022. Breastfeeding Med. 2022;17(5):360–376.Google Scholar
Jahanfar, S, Ng, CJ, Teng, CL. Antibiotics for Mastitis in Breastfeeding Women. Cochrane Database Syst Rev. 2013;(2):CD005458.CrossRefGoogle Scholar
Amir, LH, Forster, D, McLachlan, H, et al. Incidence of Breast Abscess in Lactating Women: Report from an Australian Cohort. Br J Obstet Gynaecol. 2004;111:1378–1381.CrossRefGoogle ScholarPubMed
Johnson, HM, Mitchell, KB. Low Incidence of Milk Fistula with Continued Breastfeeding Following Radiologic and Surgical Interventions on the Lactating Breast. Breast Dis. 2021;40:183–189.Google ScholarPubMed
Dagla, M, Dagla, C, Mrvoljak-Theodoropoulou, I, et al. Do Maternal Stress and Depressive Symptoms in Perinatal Period Predict the Lactation Mastitis Occurrence? A Retrospective Longitudinal Study in Greek Women. Diagnostics (Basel). 2021;11:1524.CrossRefGoogle ScholarPubMed

References

Hinchey, J, Chaves, C, Appignani, B, et al. A Reversible Posterior Leukoencephalopathy Syndrome. N Engl J Med. 1996;334(8):494–500.CrossRefGoogle ScholarPubMed
Geocadin, RG. Posterior Reversible Encephalopathy Syndrome. N Engl J Med. 2023;388(23):2171–2178.Google ScholarPubMed
Lamy, C, Oppenheim, C, Mas, JL. Posterior Reversible Encephalopathy Syndrome. Handb Clin Neurol. 2014;121:1687–1701.CrossRefGoogle ScholarPubMed
Pedraza, R, Marik, PE, Varon, J. Posterior Reversible Encephalopathy Syndrome: A Review. Crit Care & Shock. 2009;12(4):135–143.Google Scholar
Fisher, N, Saraf, S, Egbert, N, et al. Clinical Correlates of Posterior Reversible Encephalopathy Syndrome in Pregnancy. J Clin Hypertens (Greenwich). 2016;18(6):522–527.Google ScholarPubMed
Brewer, J, Owens, MY, Wallace, K, et al. Posterior Reversible Encephalopathy Syndrome in 46 of 47 Patients with Eclampsia. Am J Obstet Gynecol. 2013;208(6):468.e1–468.e6.CrossRefGoogle ScholarPubMed
Legriel, S, Schraub, O, Azoulay, E, et al. Determinants of Recovery from Severe Posterior Reversible Encephalopathy Syndrome. PLoS ONE. 2012;7(9):e44534.CrossRefGoogle ScholarPubMed
Sardesai, S, Dabade, R, Deshmukh, S, et al. Posterior Reversible Encephalopathy Syndrome (PRES): Evolving the Mystery of Eclampsia! J Obstet Gynaecol India. 2019;69(4):334–338.Google ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×