Postpartum Haemorrhage: The case study of Mrs H MODULE TITLE Complicated Childbirth MODULE CODE MW50015W/Z STUDENT NUMBER 21155785 Postpartum Haemorrhage: The case study of Mrs H This essay is based on the case study of Mrs. H. (see appendix) who suffered from postpartum haemorrhage after the birth of her second child…
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This essay will also explore the effects of postpartum haemorrhage in relationship to the case study of Mrs. H, focusing on the physical range of interventions that were undertaken to prevent fatal consequences by using oxytocic drugs and fluid replacement as per trust guidelines; care given by the Midwife and also the psychosocial care that is needed to prevent women from suffering from post-traumatic stress disorder. Mrs H was found to have ruptured her uterus affecting the involution of the uterus and therefore causing the haemorrhage. A postpartum haemorrhage is traditionally defined as bleeding from the genital tract of five hundred millilitres or more following delivery (Hofmeyr, 2001). This can result in death from hypovolemic shock. Sometimes these effects occur long after the event of the haemorrhage, which can cause women to experience psychological impact from effects such as post-traumatic stress disorder. This essay focuses on two effects that can come as a result of postpartum haemorrhage: hypovolemic shock and post-traumatic stress disorder. The basic definition of haemorrhage is the abnormal loss of blood (Varney, Kriebs, & Gegor 2004, p. 925). Intrapartum haemorrhage (IPH, occurring during delivery) and bleeding that is considered primary postpartum haemorrhage (PPH, occurring immediately after delivery) is the experience of excessive blood loss during the course of delivery or within the 24 hour period after labour and for which the source of the blood is the genital tract (Crafter 2011, p. 149). Women in labour suffer from substantial fluid loss; so they need to be kept well hydrated to ensure enough circulating volumes to enable them to cope with any excessive blood loss (Hofmeyr and Mohlala 2001, p. 646). After childbirth there is the risk of haemorrhage that can come from a variety of locations. Immediate haemorrhage is more commonly associated with mortality and can come from different factors surrounding the birth. In as much as 90% of the cases of immediate post-birth haemorrhage the cause is uterine atony which has a number of causes, including incomplete delivery of the placenta. When there are cotyledons, or retained placental fragments, there is both the risk of immediate haemorrhage and of delayed haemorrhage (Varney, Kriebs, & Gegor 2004, p. 925). The amount of bleeding can be any amount that compromises the health of the mother but is generally considered to be 500mls or more. In healthy pregnancy, women have a plasma volume increase of at least 1250mls and the red cell mass also increases, as a result women are able to tolerate up to a litre of blood loss with no adverse effects (Hofmeyr, 2001) In cases of women who suffer from severe anaemia, they may be unable to tolerate blood loss that healthy women can (Crafter, 2011). The speed of the blood flow through the intervillous space can be estimated to be about 600ml per minute (Hofmeyr et al, 2008). There are 4 most common known causes of PPH; traditionally known as the 4T: tone, trauma, tissue, and thrombin (Mukherjee and Arulkukarin 2009, p. 4). Tone refers to poor contraction of the uterus, which is also called uterine atony. The tearing of tissue and vessels known as trauma is the cause that is seen in the case of Mrs. H. The contributing factors to her ending up with a PPH were instrumental delivery, episiotomy, uterine rupture as well as genital tract lacerations. Tissue refers to when the placenta or membranes are not totally
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Post-traumatic stress disorder is an anxiety disorder that can be triggered after someone has experienced a psychologically traumatic event. A traumatic event that can spark post-traumatic stress disorder is often a life-threatening situation that an individual is personally involved in, such as feeling threatened, or else involves death, physical, psychological, or sexual virtues.
On the other hand, when this anxiety reaches more than normal levels or extreme levels based on the severity of the situations (for example: War-like situations), individuals will enter the state of helplessness and uncertainty, leading to accumulation of stress.
Moreover, the disorder is perceived to be higher in females. In this article, the researchers try to compare if a kind of cognitive behavioural therapy is better than a supportive intervention to treat PTSD among female military personnel. The researchers share that attention was focused on PTSD after several unfortunate events such as the September 11 attack, Iraq war and Hurricane Katrina.
PTSD is related to life-altering or life-threatening situations such as battlefield conditions in war, rape, assault, and other emergency situations where an individual or people closely related to an individual suffer tragic violence and the threat of death.
It is one of the fundamental beliefs of the discipline of psychiatry that traumatic events can give way to mental disorders. These disorders have been known by varied names since times immemorial until in 1980 they were formally come to be known as Post Traumatic Stress Disorder (PTSD) (Gill, 2007, p.
PTSD entails invasive and frequent memories concerning the trauma and avoiding circumstances that remind the victim of the previous trauma. The victim develops fear whenever he or she encounters a similar situation that that is likely to cause the actual events.
The onset of PTSD comes as a result of the human brain attempting to protect the individual against the intensity of the traumatic incident. It is a normal function of the brain to react in a way that promotes coping in the individual, and each person is unique in how their brain responds.
It is not necessary that every person with such emotional and physical background will develop PTSD. It varies from individual to individual and depends mainly on the duration and intensity of the event. The main issues are how the first responders of PTSD reacts after any stressful event and how can the victims of PTSD be managed through coping mechanisms and by applying one of the widely practiced method known as Critical Incident Stress Debriefing.
For those who experience the ramifications of Post Traumatic Stress Disorder, the level of doing things common to daily life can become, not just excruciating, but virtually impossible to consider as the symptoms are present. An event(s) which would have occurred, thus resulting in an injury to human psyche and mind, that can be rather debilitating to overcome.
107). There are many traumatic experiences that fall outside the ambit of what could be described as the normal human experience. PTSD is usually diagnosed in the survivors of such traumatic events. Such traumas may be of personal nature like rape or
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