Nursing care for mothers after caesarean section with early postpartum hemorrhage : 2 case study

Abstract

Postpartum hemorrhage is the most common birth complication and the leading cause of maternal mortality worldwide. Therefore, nurses caring for mothers in the postpartum period must be knowledgeable and competent in assessing risk factors for postpartum hemorrhageto prevent hemorrhage in the postpartum period. The purpose of this research was to study the nursing care of mothers with postpartum hemorrhage after abdominal cesarean section. Two mothers were compared risk factors, symptoms, signs, medical treatment, nursing diagnoses and nursing outcomes.

The results showed that the 1st case was 35 years old, the first pregnancy was GDMA1, the gestational age was 37⁺⁶ weeks, the first pregnancy had premature rupture of membrane, no labor pain, the active phase had no progressionand needed toterminatethe pregnancy by cesarean section. The 2nd case of years old, the first pregnancy, gestational age of 33⁺⁴ weeks, had twin pregnancy and preterm labor. At the period of treatment, the labor progress so rapidly then the doctor decided to terminate the pregnancy by caesarean section. From the study, it was found that both mothers had a late postpartum hemorrhagedue to poor contraction of the uterus. There were different risk factors, and the first case had a shock. Both cases had guidelines for caring as follows: assess risk factors for postpartum hemorrhage, evaluate the leading symptoms of postpartum hemorrhagewhen blood lossoccurred,assess uterine contractions, vital signs, signs&symptoms and maintain intravenous fluid, blood and blood componentsand adduterine stimulant drugs according to the doctor's treatment plan rapidly, including explaining the pathology and medical treatment to prepare the postpartum mother for procedures and medical treatment to stop bleeding and alleviate anxiety,using the concept of nursing process to provide nursing care. The results of the study showed that two mothers with late-stage postpartum hemorrhage were safe from the crisis and able to return home to live normally. All this process requires readiness and fast action with the effective team to safe postpartum mothers and minimizing the impact on life and health.

Therefore, professional nurses provide nursing care for mothers in the postpartum period should be competent in assessing risk factors for postpartum hemorrhage,providing immediate and effective nursing care in critical periodtosafe life and protected postpartum mothers from complications.