Nursing care of postpartum hemorrhage and Disseminated Intravascular Coagulation after cesarean section, due to Placenta previa totalis with uterine atony: Case study

Abstract

Pregnant women 25 years of age, G2P1, GA 36+6 weeks of the initial diagnosis; placenta  previa  totalis and previous cesarean section. A history of bleeding 2 times, Obstetrician was appointment for cesarean section and blood loss during surgery, 700 cc., Male infant, weighing 2910 grams, APGAR 9,10 . Post-operative cesarean section postpartum hemorrhage in patients with DIC. Nursing problems found are risk of Antepartum Hemorrhage, at risk of complications from spinal anesthesia, Post-partum hemorrhage due to placenta previa totalis and uterine atony, shock & DIC, and patients treated medication did not improve. The obstetrician then treated with hysterectomy (TAH) and after surgery to move into the ICU. The nursing problem after hysterectomy are the risk of hypoxia due to anemia after hemorrhage, complications of blood transfusion and blood composition, the patient is not comfortable with surgical wounds, patients and relatives are concerned about moving into the ICU and disease symptoms and treatment planning, risk of urinary tract infection and uncomfortable abdominal distension is due to the reduced bowel function after surgery. The study has provided the hospital with the knowledge, expertise and skills in the nursing process and the safe delivery of both mother and baby and discharged, including 5 days in hospital, postpartum examination, and 5 weeks of follow-up. Healthy babies, good mothers, breastfeeding.