••• Chapter 11^ The Puerperium^109
❍ What is the typical timing of postpartum psychosis?
Onset within 2 to 4 weeks postpartum, with symptoms persisting for several days to months.
❍ What symptoms are associated with postpartum psychosis?
Anxiety, suicidal/infanticidal thoughts, agitation, decreased need for sleep, confusion, disorientation, hallucination,
hyperactivity, hypersexuality, unusual thoughts, and behaviors.
❍ True or False: Women given the diagnosis of postpartum psychosis should be referred to a psychiatrist for
outpatient management.
False. Postpartum psychosis is a psychiatric emergency requiring inpatient management.
❍ How long should antibiotics be given for mastitis?
Antibiotics should be given for 10 to 14 days for mastitis.
❍ What is the first-line antibiotic for treatment of mastitis?
Dicloxacillin.
❍ What is the predominant immunoglobulin found in breast milk?
Secretory immunoglobulin A.
❍ True or False: Bromocriptine is indicated for lactation inhibition.
False. Bromocriptine is not recommended for that indication as it has been shown to have significant side effects
like stroke, myocardial infections, seizures, and psychiatric disorders.
❍ What is the treatment of breast engorgement?
Ice packs, well fitting brassiere, and oral analgesics for 12 to 24 hours.
❍ What is the most common neuropathy associated with deliveries?
Lateral femoral cutaneous.
❍ True or False: Elective cesarean section delivery should be considered after pubic symphysis separation in
prior delivery.
True. Recurrence is >50% in subsequent pregnancy.
❍ True or False: In the event of pubic symphyseal separation, orthopedic intervention is generally necessary.
False. Supportive measures should be initiated for care of pubic symphyseal separation, including a binder
positioned around the woman’s hips, and NSAIDs for pain relief until symptoms improve.
❍ What is the most important criterion for the diagnosis of postpartum metritis?
Fever.
❍ What is the preferred treatment of pelvic infection following cesarean section?
Clindamycin 900 mg + gentamicin 1.5 mg/kg IV q 8 h.