์Nursing Care of Postpartum Hemorrhage with Hypovolemic shock : Case Study of 2 Cases

Abstract

Background:Postpartum hemorrhage is characterized by the loss of more than 500 milliliters of blood during vaginal delivery and more than 1,000 milliliters during a cesarean section. It is a serious complication of childbirth and a significant cause of maternal mortality. This condition not only has physical implications but also profoundly affects the mental well-being of the mother and her family. Furthermore, it has been observed that postpartum hemorrhage can lead to long-term consequences, including anemia, which can have adverse effects on future pregnancies and deliveries. There is an increased risk of experiencing postpartum hemorrhage in subsequent pregnancies. Therefore, providing standardized and efficient maternal care during the antenatal, intrapartum, and postpartum periods is crucial to ensure the safety and well-being of mothers and enable them to lead healthy lives.

 Objective:The aim of this research is to study the nursing care of postpartum patients who have experienced hypovolemic shock following childbirth. This will be accomplished through a comparative analysis of two case studies.

 Method: This study involved a comparative analysis of two cases of postpartum patients who had experienced hypovolemic shock. The research compared their pregnancy histories, risk actors, and nursing procedures. Data were collected using various tools, including medical records, interviews with the patients and their families, and a study period that encompassed the months of April to June in the year 2023 for both cases.

 Results:Both of the postpartum patients encountered similar nursing care issues, namely postpartum hemorrhage. However, there were differences in the underlying causes and the severity of complications that ensued.Case 1, a 39-year-old patient with a history of multiple pregnancies, was at risk from the antenatal period. Postpartum, she experienced postpartum hemorrhage. An ultrasound revealed retained placental tissue, prompting manual removal.Case 2 involved an assessment of the patient before transferring her to the patient ward. The patient experienced symptoms such as dizziness, cold sweats, and altered vital signs, including an increased heart rate, decreased blood pressure, and reduced blood oxygen levels. Both patients suffered from hypovolemic shock and received urgent and expedited assessment and treatment. Both received similar primary treatments, including intravenous fluids, blood transfusions, uterotonic medications, uterine massage, and close monitoring of vital signs. Nursing care issues were resolved after ensuring the safety of the patients, and they were subsequently transferred to the patient ward for further care.

 Conclusion: Postpartum hemorrhage with varying causes and severity is a significant risk. Nurses must possess the competency to assess and identify risk factors for bleeding from the very beginning. Collaborative interdisciplinary teamwork is essential to address issues promptly and appropriately. Implementing nursing procedures efficiently is crucial for the effective care of postpartum patients with hemorrhagic shock, which can ultimately contribute to reducing maternal mortality rates.