Nursing care for a mother who has Shoulder Dystocia with Postpartum Hemorrhage : case study.

Abstract

     This study is a case study. The objective was to study nursing care for a mother who had Shoulder Dystocia with Postpartum Hemorrhage. The study was conducted on a 35-year-old mother with a history of a second pregnancy, 39 weeks and 4 days of gestation, who presented with labor pains 4 hours before hospital admission. During the prenatal period, she was uncomfortable from labor pains and at risk of receiving drugs to induce uterine contractions. During labor, shoulder dystocia occurred for 2 minutes. The right episiotomy was widened more than normal, and the shoulder was delivered using the McRoberts maneuver and suprapubic pressure. The neonate was born male with Apgar scores at 1, 5, and 10 minutes of 7, 8, and 9. The neonate weighed 3,960 grams. The left arm was movable horizontally; it showed a full normal placenta, and total blood loss was 520 ml.  The mother had a postpartum hemorrhage, and then the mother received a stimulant uterine contraction drug and a uterine massage. After that, the uterus contracted well. There was no additional vaginal bleeding or Episiotomy. Therefore, the mother and neonate were sent to the obstetrics and gynecology ward for further care. A follow-up visit revealed that the mother's general condition was normal. The doctor therefore discharged her home. The total length of stay was 3 days. The neonate's left arm moved less one day after birth, and vomited after sucking milk. The pediatrician therefore transferred the neonate to the pediatric ward and diagnosed a brachial nerve injury and consulted a physical therapist to rehabilitate the nerves and muscles. Later, the neonate developed jaundice and received phototherapy for 2 days. Jaundice symptoms and bilirubin levels decreased, so the doctor discharged the neonate home. The total length of stay was 4 days.