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University of Washington乳腺炎华盛顿大学ppt课件
Mastitis;Thanks to ;Case Presentation;At 6 week visit, she reports 2 episodes of moderately painful swelling in upper inner quadrant of R breast; it occurred once in L breast
It usually resolves, but she wants to know why it happens, and what to do;Exam:
Afebrile
Looks tired but otherwise well
Normal nipple and breast; no lumps or indurated areas
No skin changes or lymphadenopathy;Exam:
Afebrile
Looks tired but otherwise well
Normal nipple and breast; no lumps or indurated areas
No skin changes or lymphadenopathy
Dx: Milk stasis or “plugged duct”;Risk factors for milk stasis:
Fatigue, stress
Infrequent feeding
Incomplete emptying of breast
Ill-fitting bra
Pumps, shields
Prior breast trauma or infection;Treatment for milk stasis:
Heat application
Massage toward nipple
Frequent, relaxed nursing
Change position to promote emptying
Avoid pumps, shields;Pt calls you Sunday afternoon, 3 PM, now 7 weeks postpartum
Had recurrent swelling of upper inner quadrant R breast yesterday, but didn’t resolve
Now 2 hrs of fever, chills, increased tenderness;Pt calls you Sunday afternoon, 3 PM, now 7 weeks postpartum
Had recurrent swelling of upper inner quadrant R breast yesterday, but didn’t resolve
Now 2 hrs of fever, chills, increased tenderness
Dx: Acute mastitis;Incidence: 2 - 3% of lactating women;Incidence: 2 - 3% of lactating women
More common at 2 - 6 weeks post-partum, but can occur at any time;Incidence: 2 - 3% of lactating women
More common at 2 - 6 weeks post-partum, but can occur at any time
More common in primiparas, but probably due to bias;Incidence: 2 - 3% of lactating women
More common at 2 - 6 weeks post-partum, but can occur at any time
More common in primiparas, but probably due to bias
Risk factors: milk stasis, age 30, stress, fatigue, professional employment of mother or father;Normal breast architecture;1970 Series:
71 cases of acute lactational mastitis
Peak incidence at 2-3 weeks postpartum
No infants weaned; none became ill
11% developed abscesses; 75
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