WOMENS-HEALTH Messages for March, 1997: Re: 6wk post partum exam-physicians please

Re: 6wk post partum exam-physicians please

From: R.Daniel Braun, MD (anonymous@obgyn.net)
Sun, 30 Mar 1997 10:46:31 -0600 (CST)

Messages sorted by: [ date ][ thread ][ subject ][ author ]
Next message: Roberta: "Hey Pfizer we really love Zoloft! How about being our Sponsor;-)"
Previous message: Sonja: "6wk post partum exam-physicians please"
In reply to: Sonja: "6wk post partum exam-physicians please"

At Sun, 30 Mar 1997, Sonja wrote: >
>I would like to know what to expect at a routine 6 wk post partum
>appointment for a woman who has had a c-section. What could I expect as
>part of the physical exam? Additionally, what investigations would you
>consider for the woman when her macrosomic baby was stillborn?
>
>Thank you very much.
>
>--
>Sonja
>

The 6 week postpartal exam following cesarean delivery is much the same as following vaginal delivery. The nurse usually checks weight, BP and temperature. Then the history is covered as to any problems since the delivery with particular questions relating to urination and defecation. Also I enquire about dificulties with feeding the baby, depression, ability to rest, help with the baby, and what activities have been resumed. I also ask about contraception and the resumption of sexual activity. (Most of my patients have because I usually tell them it is OK after 2 weeks if they feel up to it. This is based on some studies done several years ago where it was found that when they were told 6 weeks, many folks waited 2 weeks, had no problems, but felt extremely guilty about it.) The examination should include evaluation of the breasts, a careful abdominal exam(with special attention to the incision), and a complete pelvic exam with pap smear. Following the exam, adiscussion is had based on the topics that have been raised during the history and exam. As to the evaluation of the woman who has had a stillborn macrosomic infant, one needs to check for Diabetes. This can be done by getting a Hemoglobin A-1-C in the hospital before discharge. It also can be done by Glucose tolerance test at the 6 week check or shortly thereafter. If those are normal, the patient should be evaluated for diabetes early in her next pregnancy and again at 28 weeks in her next pregnancy. This is because a woman can develop "Gestational" Diabetes and have no evidence of diabetes when she is not pregnant. Other things that lead to macrosomia should also be checked but these vary depending on ethnic and genetic backgrounds of the parents, size of the parents, etc.

--
R.Daniel Braun, MD  FACOG
Clinical Professor of Obstetrics and Gynecology
Indiana University School of Medicine
Indianapolis, IN
                                      "Heisenberg might have slept here."
                                          Unknown or maybe Indecisive                                               Unknown

Next message: Roberta: "Hey Pfizer we really love Zoloft! How about being our Sponsor;-)"
Previous message: Sonja: "6wk post partum exam-physicians please"
In reply to: Sonja: "6wk post partum exam-physicians please"

Women's Insurance Checklist from Auto Insurance Quote

use when must restrict search to only the women's health forum...
Enter search keywords:
	Returns per screen: Require all keywords: