Question

A 30-year-old Jehoveh Witness woman with Multiple Gestations, with Marginal Placenta Previa, delivered 1 hour ago

Count pad is 2 saturated pad since delivery. She is refusing the tocolytic,

Fundus is boggy, deviated to the left, and at 2 cm above the umbilicus.

Upon assessment patient hypotensive, and tachycardic, and Hgb is 6/ Hct 18.

How do you manage?

Answer 1

• Emergency care including intravenous fluids, blood or both, is needed.
• Maximize oxygen delivery - Completed by ensuring adequacy of ventilation, increasing oxygen saturation of the blood, and restoring blood flow.
• Control further blood loss.
• Health education given to the patient and family about importance of tocolytic medications in this condition.
• Provide psychological support to the patient, it helps to decrease anxiety.
• Manual removal of placenta and clots. Uterine tamponade and uterine artery embolization.