The contents of this section, corresponding to the discharge information sheet of the obstetric ward
I. For women who are hospitalized due to illness but did not deliver After discharge: (1) Go to the outpatient maternity ward within the specified time or for re-examination, especially if there is too little or too much amniotic fluid, abnormal blood sugar, high blood pressure, poor fetal heart monitoring, low self-perceived fetal movement, irregular abdominal pain, bile stasis, etc. Please count your own fetal movement and pay attention to the condition of fetal movement at the corresponding time of day. (2) Vaginal bleeding during pregnancy (e.g. placenta praevia or placenta with lower edge close to the uterine orifice, or placental blood sinus, or cervical polyps with obvious inflammation, etc.), please take care of bed rest and avoid actions that increase weight and abdominal pressure (e.g. laughing, constipation, reporting children, sitting on a low stool, sexual intercourse, etc.).
Please record the hospitalization number (= case number) in your cell phone for easy reference when you come to the hospital. Bring all previous relevant disease information when you visit the clinic or come for consultation. This number is usually available for patients who report on Dr. Guo Peifen’s
II. Maternal postpartum problems
1. Postpartum review Measure blood pressure, blood sugar, ultrasound suggesting abnormal echogenicity in the uterine cavity, anemia, etc. It is advisable to come to the hospital for corresponding examination 1 week after delivery. Routine screening 42 days after delivery, usually on Tuesday or Thursday afternoon. For newborns, you can register for the neonatal unit. If your baby has had child health care during the vaccination in the community hospital at full term, you do not need to bring your baby to our department for review at 42 days, and the mother herself can return to the hospital for review.
2. Postpartum bleeding Generally, within 42 days, there will be repeated small amount of bleeding; many people show that they do not bleed for a few days, but suddenly bleed again. 2 months after cesarean section, irregular bleeding is still possible. It is usually related to diet (sudden consumption of hotter food or herbs to activate blood, etc.), mood swings, and exertion; a few may be related to residual placenta-fetal membranes in the uterus, inflammation, and very rarely to uterus-related tumors. Patients who have been informed of abnormal echogenicity in the uterine cavity during hospitalization, intrauterine cesarean section suggestive of placenta implantation, or hand entry into the uterine cavity for placenta retrieval during vaginal delivery should improve their physical fitness in plain and come to the hospital for timely treatment.
3. Pelvic floor rehabilitation The extrusion of the fetal head on the pelvic floor is very likely to damage the pelvic floor, leading to pelvic floor laxity, distant postpartum vaginal wall prolapse, urinary incontinence, unsatisfactory sexual life, etc. Please bring the “pelvic floor function training probe” (issued by the hospital) to the 16 consultation rooms for pelvic floor rehabilitation during the postpartum follow-up. Combined with Kegel exercises, it is more effective to prevent and treat vaginal prolapse and prevent uterine prolapse for women, see below.
4.Postpartum breast care It is advisable to use more breast supports. If you have too little milk, too much milk, or do not want to breastfeed and ask for back milk, see the related article on Dr. Pei-Fen Guo’s website or ask Dr. Guo to send you related information. Breast inflammation, manifested as swollen and painful hard lumps, it is advisable to express both breasts empty, do not let milk accumulate in the mammary glands, after breastfeeding, and wash the teats with water to prevent children from biting the skin of the teats and learn the correct way to express milk. Please ensure sufficient rest and sleep and insist on exclusive breastfeeding for 4-6 months to feed your baby. Breastfeeding hotline number: 020-61627275.
Many mothers consult me through the platform, after they go home, they find a lump growing under the armpit, which is very painful, what is the matter? Most of this situation is the parammary gland, by the action of lactogenic hormone, it becomes larger, and the milk can not come out. Don’t squeeze it, just pay attention to hygiene and don’t worry about it; cancer is extremely rare.
Some mothers report that their children can sleep only when they are holding the nipple, otherwise they always cry and may not be fed enough. a. If you hold the nipple for a long time, it is easy to bite it and bleed, and when children suck it into the stomach, they sometimes vomit milk, which is coffee-colored and easily confused with gastric and gastrointestinal bleeding in children; it is also easy to cause breast infection and mastitis. If the child is asleep, just take out the nipple (or latex nipple). When the baby eats, it does not suck and goes to sleep, then pinch the baby’s feet or ears, pat the little buttocks, do not let fall asleep; or add some milk powder, both have good results.
The newborn baby has a very small stomach, very flat, very anxious to eat milk, eat more, there is a gap between the pacifier and the child’s mouth, sucking more air into the stomach, eat after lying flat, very easy to spit up milk. It is recommended to hold the child upright after feeding, patting the back. If you sleep on your side, when you vomit, the milk will come out easily on its own, and it will not be easy to choke on the throat and trachea.
5. Contraception Sexual intercourse is forbidden within 42 days after delivery and before the blood is clean. Irregular menstruation during breastfeeding, easy to accidental pregnancy. Condom contraception is suitable; or natural birth 3 months after delivery (6 months after cesarean section) on the ring; if you have another child, at least 1 year after natural birth, otherwise miscarriage and premature birth are likely to occur; at least 1.5 years after the cesarean section, and then start to prepare for the next pregnancy. The risk of placental implantation and uterine rupture during re-pregnancy is serious.
6. Maternal health care system management handbook Please submit the pregnancy management handbook to the community health service center (station) in your household or place of residence within 3 days after discharge from the hospital after delivery, and apply for the return receipt.
7. Postpartum toothache, can’t poop: Some mothers eat too much supplement, get fire, export sores, toothache, or don’t eat vegetables, can’t poop, are not right.
8, postoperative wound problems abdominal or perineal wounds absorbable thread generally do not need to be removed. Metal suture removal is extremely simple, a thread pulled out at once, and no pain, there is no foreign body residue in the wound after removal; in the past, it was sewn with silk thread, a stitch by stitch, pain. The dressing can be removed in another week or so after the stitches are removed. Wounds are generally more fragile, avoid long time soaking in water, 10 days after cesarean section, you can take a bath, and require about 3 minutes to finish bathing. Avoid local vigorous pulling and repeated rubbing of trouser belt; abdominal fitness exercise (such as sit-up-like exercise) is advisable to wait until 2 weeks after surgery to start, or from easy to difficult, no need to force.
Some wounds bleed pus or even split open after returning. When this happens, please refer to the relevant articles on my website. Some people go back to make up too much fire and heat toxins gather in the wound. Need to come to the hospital to change the medicine, some trouble, be patient, about a month, usually grow well.
A few women go home for a few days, perineal wounds, or half a month after the threads are not absorbed, you can come to the hospital to cut the threads, the wound will heal faster.
9, postpartum mood and spirit There is a 20-year-old couple, outside the hospital, 6 days of normal delivery, the mother lower abdomen severe pain 120 to our hospital. The results of physical examination, blood test and ultrasound were good. The woman was crying, and the man had a black face and didn’t say a word. The woman said I gave birth to a child, it is not good for me, let end a water also refused; the man said, I work very hard, tired, home also just want to rest; the woman said, you do not like the birth of a girl, refused to go home, but also beat the child; the man said, I did not dislike the daughter, I also go home, only the house is small, the child noisy, sleep is not good, only back to their parents’ home, and you let me go. At this point, the girl’s mother said, I take care of the children, but also tired, you just bad for my daughter. The man said, you took away my house keys, how do I go home. I said to the girl, take away the man’s keys, but a big wrong oh. The woman is angry, said, yes, I am wrong, it is my fault, said while crying, to dial the needle out of bed not to cure. More understanding, more take charge of it …. Women give birth to children is very hard, with children is even harder, to take care of, but when you can, to rely more on themselves. The man himself to do a good job, do not just play with the phone and the Internet, do not get involved with flowers; men to bear the humiliation, the old, the young, to have the method and skills; women are not queens. Social pressure is very high, only to run their own small home, in order to live a good life.
10, postpartum bathing advocate personal hygiene, no cold water, cold water, bathing and shampooing water with some mugwort, ginger boiled water. When it is cold, wear gloves and socks, when it is hot and sweaty, it is advisable to take a bath in time, etc.
11, hospital with medicine birth insurance and medical insurance patients, the dose of medicine brought after childbirth is limited. Most women will bring a few boxes of motherwort capsules (to promote contractions and drain blood stasis), vajra capsules), blood nourishing capsules (to correct anemia), calcium supplements and multivitamins (especially for patients with high blood pressure, but breastfeeding, it is advisable to supplement them), blood life gum capsules or breast enhancement cream (some patients are discharged from the hospital with a good amount of milk, but some doctors also routinely prescribe drugs to produce breast milk, in fact, it is possible to bring back, there are often Mothers say their milk started well and suddenly slowly became less, so it is helpful to take some medicine to increase breast milk), hemorrhoid cream, etc.
If you have taken too much medicine and you are still bleeding irregularly, you can buy “(new) biochemical granules” at the pharmacy and drink some motherwort and mugwort water by yourself.
Third, the problem of young children
Even if no abnormalities are seen at the time of discharge, jaundice, diarrhea, fever, refusal of milk, crying, purple lips, rash, urine and stool with abnormal color and smell, etc. may appear soon after leaving the hospital.
2. Neonatal jaundice The difference between physiological and pathological jaundice (e.g., face/forehead/upper chest/sclera) is not obvious, but the outcome varies greatly, and in severe cases bilirubin encephalopathy (affecting intelligence, hearing, etc.) may occur; parents should pay attention to changes in skin yellowing, urine color, etc. Since most parents do not observe these indicators, please come to the hospital at least once a day to check the jaundice index, etc.; be careful about giving the infant herbs, antipyretics, and using camphor to avoid adverse outcomes.
Discharge from the hospital after 48 hours of normal delivery, skin test 18/18 19/18 or more, and ask to follow up within 1-2 days, and ask for pediatric consultation before discharge if it is too high.
Cesarean section, the day of surgery is not counted, full 5 days discharge, 20/20 21/20 21/22 or more instructed to follow up, and only after pediatric consultation if too high.
A small amount of gardenia yellow granules 15 (5 packets) can be receding yellow, but the drug is more cold drying; mamma’s love punch 15 (1 box), improve the gastrointestinal tube flora of young children.
3, the newborn hearing does not pass, please come to our pediatric department to review at 42 days after birth.
For patients who have undergone cord blood testing for neonatal deafness, if there are 1-2 red mutations on the report form, please note that the child’s ears and hearing need special protection, such as not hitting the ears (ear scraping), pulling his/her ears, not using or minimizing the use of drugs that may damage the ears (such as ototoxic antibiotics, quinolones, etc.), etc., and not marrying a child who also has the corresponding mutation when the child grows up. The child should not marry a person who also has the corresponding genetic mutation.
It is best to have both hearing screening and deafness genetic testing. Sometimes, even if there is a problem with the deafness gene, the hearing is good and does not affect the life of the person. There are also cases where the deafness gene is not abnormal, but there is a problem with hearing, which requires review and specialist examination and treatment of the ear and hearing.
4. For babies with birth weight > 2000g, the first dose of hepatitis B vaccine has been given during hospitalization, please return to the street community health service of your household registration or temporary residence section for vaccination and child health care when your baby is one month old. Children with household registration or temporary residence in Xinghua Street of Tianhe District can go to our community vaccination on Monday and Wednesday afternoon.
5.Baby has been vaccinated with BCG vaccine, about two weeks the left arm vaccination site appears red and swollen, about 1 month in the vaccination site appears a small hard lump or small pustule, do not wrap gauze. If pus flows, pay attention to keeping the area dry and clean, and it will start to scab in 2 months, and the scab will fall off in about 3 months, leaving a scar, which is a normal reaction.
6. Umbilical cord care After discharge, the umbilical cord is ligated and waiting for natural shedding. Untie the umbilical cord before bathing every day (some people are afraid that the umbilical cord will be wet with water blisters, so they cover it with umbilical stickers and do not untie the umbilical cord), and dry it with a clean cloth or cotton swab after bathing. If there is a little blood, you can buy Yunnan Baiyao capsules and sprinkle the contents of the capsules on the umbilicus and then wrap it.
A little yellow mucus and odor in the area before the umbilical cord falls off is not an infection. If you need to go back to the hospital for treatment, please go back to the Baby Friendly Zone of the Obstetrics Department of the Armed Forces Hospital from Monday to Friday afternoon every week.
7. Newborn screening Please check the screening results online one and a half months after birth, and note that there will be an SMS notification if there is any abnormality, please return to the hospital for review according to the guidelines.
8. Scalp edema and hematoma The fetal skull and the pelvis of the delivery woman squeeze, the scalp and vaginal tissues are edematous, the fetal scalp edema, the skull stretched long, is very conscious, usually 48 hours to improve. Subscalp hematoma, is a soft bag under the scalp, with fluctuating sensation, do not squeeze it, some more than 2 years to completely disappear, most because of spontaneous rupture of blood vessels in the scalp eye, clotting mechanism abnormal grip.
9, skin erythema and nasal yellow spot scalp erythema, can be here and there, the size varies, may be intrauterine heat (pregnant women’s body heat) and postnatal package too hot related. Pay attention to skin hygiene, sometimes eat a little more Yinhua water will be good, or wash with more Yinhua bath. Most newborns have a lot of yellow pinpoint-sized dots on their noses, so don’t worry about them.
10, the problem of red buttocks and ringworm The red buttocks cream purchased from Hong Kong is good. Eczema on the face (some people call it ringworm), wash with honeysuckle water, some people have good results, if the effect is not good, you should come to the hospital in time.
11. Blood clots in the eyes: Some children come home with a red spot in the sclera of their eyes, which usually does not matter and will disappear on its own if the child avoids crying too much.
12, blood in the urine: some children urine drops on the diaper, red, as if there is blood in the urine. Its otherwise, observe for a few more days and it will be fine.
13, sleep is not solid: some children in the month, sleep is not solid, easy to wake up, some prone to convulsions, it is recommended to eat some vitamin AD pills to observe a few days; if there is no improvement, promptly respond to the doctor.
Fourth, the birth certificate
1. Time: Every Tuesday/Thursday from 14:30; 2. Place: Obstetrics and Gynecology consultation area on the fourth floor of the outpatient building – birth certificate issuance room.
3, requirements: (1) the mother of the child to come to apply (before printing the birth certificate need to check carefully to prevent errors; other relatives to pick up, need to entrust the certificate, etc., very troublesome, please try to avoid other people to come); (2) the name of the child; (3) bring the original ID card of the couple and a copy of the ID card; (4) the discharge statement; (5) please call ahead to make an appointment 020-61627365. Once the birth certificate is issued, it will not be changed.
V. Other health education
1. When there are many areas of clinical crossover between physiology and pathology, i.e., when the self-consciousness is not normal but does not reach the admission criteria (or when no abnormal indicators are seen in the current western medical examination), please ask the patient to consider whether to go home for observation according to their own medical knowledge and life experience; if they cannot grasp it, please admit to the hospital in time to avoid unnecessary disputes. Please understand that it takes a certain amount of time for the disease to evolve and for tests and examinations to be performed, so it takes a considerable amount of time for the hospital to give a clear diagnosis (clinical diagnosis, experimental or imaging diagnosis, pathological diagnosis, all of which have different meanings). In order to make a clear diagnosis and exclude possible related diseases as soon as possible, more and non-routine tests are needed.
2. Patients are asked to manage their lifestyle (diet, exercise, emotions, physical examination, treatment) to achieve good health. Dr. Pei-Fen Guo recommends that you read about this website to improve your understanding.
3. Please take the initiative to write down your questions in advance and study on your own; communicate with your doctor at the appropriate time when he/she is checking in or out of the clinic.
VI. Kegel Exercise
Kegel exercises can effectively prevent and treat vaginal prolapse and prevent uterine prolapse in women.
Simple method: pelvic floor muscle exercises can be performed anytime and anywhere, with the regularity of contracting for five seconds and releasing for a second, while walking, riding in a car, or at the office.
Standard method: After delivery, you can perform the following self-training exercises every day (24 hours after delivery): 1. lie flat on your back with your knees bent. 2. contract the muscles of the buttocks and lift the anus upwards. 3. close the urethra, vagina and anus tightly (they are supported by the pelvic floor muscles at the same time), which feels like the urge to urinate, but you cannot go to the toilet and need to close the urine. 4. imagine that you are using your vagina to attract something, such as a stuffing or a penis. Imagine lifting from the entrance of the vagina, then gradually rising along the vagina and supporting it for 3 seconds. Repeat 10 times as a group, gradually increasing to 25 times a day for 3 or more groups. 5. Make the vagina descend as if you were squeezing something out of it, such as a magnetic shrinkage ball. Repeat 10 times as a group of 3 or more groups per day, gradually increasing to 25 times per group. 6. Keep the pelvic floor muscles contracted for five seconds, then slowly relax, and after five to ten seconds, repeat the contraction. 7. Breathe as usual throughout the exercise and keep the rest of your body relaxed. You can touch your abdomen with your hand, if there is a tightening of the abdomen, then the exercise muscle is wrong.