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Mwesiga Hamphrey; Muramuzi Edwin
The fourth stage of labor spans from placental delivery to the subsequent six hours, marking the beginning of the postpartum period and requiring vigilant monitoring for life‑threatening complications. Common maternal issues include pain, perineal discomfort, urinary retention, and postpartum hemorrhage, while neonates may experience hypothermia and hypoglycemia. The guide outlines systematic assessment of uterine tone, fundal height, lochia output, and vital signs, as well as interventions such as uterine massage, bimanual compression, and analgesia. It also addresses puerperal infections, their pathophysiology, differential diagnoses, investigations, and antibiotic therapy. Finally, it discusses breastfeeding in the context of HIV, outlining WHO PMTCT guidelines and contraindications for lactation.
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