Postoperative complications

Abstract

Minor complications, if neglected, too often become major complications with potentially serious consequences and, although this chapter is concerned primarily with conditions carrying major risks in terms of mortality or long-term morbidity, it should not be assumed that minor complications are unimportant. Many postoperative problems are the final link in a chain of event starting in the antepartum and intrapartum periods. In such circumstances, without a disciplined approach it is easy for a state of fluid imbalance and biochemical and metabolic turmoil to develop and subsequent evaluation and treatment can become difficult and complex. Severe postpartum problems are becoming less common as a result of improved intrapartum care, increased vigilance, less empiricism, and more carefully planned and logical treatment. Expert assistance is often required in the managment of the more complex and life-threatening conditions such as severe infections or impaired renal function. It is important to seek such help at an early stage rather than to wait and expect to be rescued when the picture has been further confused by treatment which might not be entirely appropriate. The majority of postpartum complications have as their main presenting feature either shock, with or without blood loss and hypovolaemia, or pyrexia, with or without infection. Secondary and associated problems include coagulation disorders, pulmonary embolism, impaired renal function and pituitary necrosis.