Nursing Care of Severe Postpartum Hemorrhage with Hypovolemic shock : case study

Abstract

     This study was case study aimed to study  in nursing care  hypovolemic shock form Early severe postpartum hemorrhage by using 2 comparative case studies. who admitted  at  labor room  in  Kosumphisai  hospital. And The  result after refer to the host hospital. Data were collected from in  patient medical records.  comparative were use  pregnancy history , Risk factor, pathology, treatment ,signs and symptoms ,nursing diagnosis, and nursing outcomes .

                The Result :Both case  there are  difference in cause  but Same  nursing  problems : Hemorrhagic shock after deliveries .The1^st. Case was the Thai pregnant gravidity2^nd. in the1Stage of labor Found: Fetal distress. obstetrician set cesarean section Emergency  in  during : Spontaneous membrane rupture after 1 minute  about, parturient seizure  Symptoms Unconscious. and the later have good conscious. Per vaginal  Examination  found cervical Fully dilate. The Doctor  performs Normal Delivery new born weight2,795 grams APGAR Score0,4,5  after placenta Delivery Uterine Atony Estimate 1,300ml.bloodloss with  hypovolemic shock .The doctors Stop bleeding  using Condom uterine Balloon Tamponade and Referral to the host  Hospital, post   to treatment Stop bleeding by  hysterectomy , and Found   Complication Disseminated Intravascular Coagulation the  parturient died.The2^nd. case was the Thai pregnant gravidity 4^th. with a High risk  was diabetes and Obesity. on admission Cervical fully dilate , normal Deliveries newborn weight 3,555grams. APGAR Score 9-10-10 After birth was  retained of placenta ,obstetrician to do manual removal of placenta in the  operative room , total 1,100ml blood loss With hypovolemic shock ,parturient safety, tubal resection was done  and  discharge.    Both of case have the same therapy : IV fluid, Blood component, drug, uterine massage and closed monitoring. Differences Condom balloon Uterine  tamponade Replacement for stop bleeding in The1^st case.and the  2^nd case was placenta removal.