Nursing care for Mothers after caesarean section with early postpartum hemorrhage with severe hypovolemic shock : 2 case study

Abstract

Objective : This study was to compare nursing care for mothers after cesarean delivery who have postpartum hemorrhage combined with severe shock between 2 case studies in mothers admitted to the obstetrics ward,  MahaSarakham Hospital during 2021-2023.

Methods : Collection of information from the patient's medical record,  Interview patients and relatives analyze data by comparing according to Gordon's health pattern, pathology, signs and symptoms and nursing outcomes.

Results : Patient case 1 was second pregnancy with  twin and labor pain and anemia. Have a history of having a cesarean section in the first pregnancy This birth was performed by emergency cesarean section. After the cesarean section, it was found that the uterine atony. Vaginal bleeding leading to shock treated with medication and repeat surgery by hysterectomy. Total blood loss is approx. 2,800 ml. Nursing cares were to prevent shock and decrease anxiety.Total treatment period was 5 days. Patient case 2, was pregnant for the second time and had a history of having had a cesarean section in her first pregnancy. Make an appointment for abdominal childbirth surgery together with sterilization. After surgery, it was found that there was bleeding in the abdominal cavity, Hypovolemic shock. treated with medication and repeated surgery  2 times, the first operation was hysterectomy with bilateral salpingectomy , the second operation the Hypogastic uterine artery were ligated. The cause of postpartum hemorrhage is a tear in the lower uterus. Total blood loss is approx. 4,900 ml. Nursing cares were to prevent shock and decrease anxiety. Total treatment period is 6 days.

Conclusion : Nurses must have knowledge, skills, and ability to make decisions to quickly and efficiently provide assistance to postpartum mothers in the critical period. To keep mothers safe and no complications.