Nursing care of premature mothers with shock due to early postpartum hemorrhage: case study

Abstract

     The objective of this case study is to research the cause of preterm delivery and postpartum hemorrhage processing which effect to both mother and infant. The nursing care in each patient and take the results to be a body of knowledge of nursing care for a patient with postpartum hemorrhage. The result of case study from labor room at Konsarn hospital, the patient’s obstetrics history; 16 year old woman primigravidarum (G1P0A0L0), uncertain last menstrual period with no antenatal care. Gestational age 32 weeks from an ultrasound examination. Blood tests show; Hct: 27.5%, VDRL: Non-reactive, HbsAg: negative, blood group: AB. the patient presented with labor pain and a large amount of bleeding per vagina 4 hours before arriving at the hospital. Vital sign first assessment; body temperature 37.2 degree celsius, pulse rate 100 times per minute, respiratory rate 20 times per minute, blood pressure 90/60 mmHg, look anxious, she recieve 0.9% NSS 1000 ml, free flow 500 ml. Per vagina examination; cervical os 9 cm, effacement 100% then refer to labor room for normal labor, 2 degree tear, a boy infant body weight 1,235 gram, good active, Apgar score at 1,5 minutes = 9,10. There are active bleeding per vagina after third stage of labor, then the patient was treated with Oxytocin 20 units in 5% D/NSS 1000 ml intravenous injection 100 ml per hour, Methergin 1 ampule intramuscular injection, uterine massage and the bleeding stop within 3 minutes. Estimated blood loss is 600 ml, vital sign; body temperature 37.2 degree celcius, pulse rate 100 time per minute, respiratory rate 20 time per minute, blood pressure 90/50 mmHg, the physician would like to add the 2nd intravenous fluid for RLS 1000 ml, free flow 500 ml and PRC 2 units, then referred to obstetrics department at Chaiyaphoom hospital along with low weight preterm infant.