Postpartum Hemorrhage Care Plan for a Patient with Placenta Previa

This case study presents a postpartum hemorrhage (PPH) care plan for a 42-year-old woman, Candace Evans, who underwent an elective lower uterine caesarean section (LUCS) at 38 weeks gestation due to placenta previa. The assignment details the patient's pre-operative assessment, including her history of gestational diabetes, depression, anxiety, and post-natal depression. Upon arrival in the Post-Anesthetic Care Unit (PACU), Candace's vital signs, dermatome level, and current intravenous therapy of Oxytocin are assessed. The care plan addresses the sudden increase in vaginal bleeding, indicating PPH. The case study explores the pathophysiology of PPH, risk factors, and various management strategies, including the use of uterotonic agents and monitoring for signs of shock. The care plan also addresses the patient's history of postpartum depression and potential impact on parent-child interaction. The plan incorporates evidence-based interventions and monitoring parameters to ensure optimal patient outcomes, drawing on resources such as medical journals and textbooks to support the care provided.

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Resources used.
Arduini, M., Epicoco, G., Clerici, G., Bottaccioli, E., Arena, S., & Affronti, G. (2010). B‐Lynch
suture, intrauterine balloon, and endouterine hemostatic suture for the management of
postpartum hemorrhage due to placenta previa accreta. International Journal of
Gynecology & Obstetrics, 108(3), 191-193.
I could not find the pdf version of this article so kindly check it online on this doi
https://doi.org/10.1016/j.ijgo.2009.10.007. it is a summary of the surgical modalities used in
management of pph. I mentioned them in under subheading post-partum hemorrhage.
Fan, D., Xia, Q., Liu, L., Wu, S., Tian, G., Wang, W., … Liu, Z. (2017). The Incidence of
Postpartum Hemorrhage in Pregnant Women with Placenta Previa: A Systematic Review
and Meta-Analysis. PLoS ONE, 12(1), e0170194.
http://doi.org/10.1371/journal.pone.0170194
I have provided the pdf to this article. I have also highlighted the points I used including
incidence of pph in placenta previa.
Field, T. (2010). Postpartum depression effects on early interactions, parenting, and safety
practices: a review. Infant Behavior and Development, 33(1), 1-6.
Kindly access it from doi https://doi.org/10.1016/j.infbeh.2009.10.005 i used this article in the care plan
for altered parent child interaction since the patient had a history of post partum depression.
The article simply describes the importance of screening for postpartum depression considering
risks to infant

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Gashi, A. M. (2016). Postpartum Hemorrhage post Placenta previa Centralis-Conservative
Management. A case report. I have attached this pdf. It is a discussion on placenta previa
and pph. Most of the pathophysiology of placenta previa came from this article.
Hasegawa, J., Nakamura, M., Hamada, S., Matsuoka, R., Ichizuka, K., Sekizawa, A., & Okai, T.
(2012). Prediction of hemorrhage in placenta previa. Taiwanese Journal of Obstetrics
and Gynecology, 51(1), 3-6. doi:https://doi.org/10.1016/j.tjog.2012.01.002
I have attached the pdf to this article. It emphasizes the causes of bleeding in placenta previa.
This based my discussion on why patients with placenta previa get pph.
Hull, A. D., & Resnik, R. (2010). Placenta accreta and postpartum hemorrhage. Clinical
Obstetrics and Gynecology, 53(1), 228-236. I did not find the pdf to this article but you
can preview it on doi 10.1097/GRF.0b013e3181ce6aef it discusses one of the complications of
previa which is accrete and the abnormal separation of the placenta during delivery offering one
of the causes of pph in previa.
Konar, H. (2014). DC Dutta's Textbook of Obstetrics. JP Medical Ltd.
this is an obstetrics textbook and I refernced it widely including pathophysiology of pph, previa
and management of pph.
Oyelese, Y., & Ananth, C. V. (2010). Postpartum hemorrhage: epidemiology, risk factors, and
causes. Clinical Obstetrics and Gynecology, 53(1), 147-156. doi:
10.1097/GRF.0b013e3181cc406d check this doi. This article provides a basic
epidemiology of pph and its influence on maternal mortality. I used it in the introduction
to pph.

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Pacagnella, R. C., Souza, J. P., Durocher, J., Perel, P., Blum, J., Winikoff, B., & Gülmezoglu, A.
M. (2013). A systematic review of the relationship between blood loss and clinical
signs. Plos One, 8(3), e57594. Under care plan, there monitoring of signs of shock and
vital signs. This is the parent article. I have provided the pdf.
Rajan, P. V., & Wing, D. A. (2010). Postpartum hemorrhage: evidence-based medical
interventions for prevention and treatment. Clinical Obstetrics and Gynecology, 53(1),
165-181. Check this doi doi: 10.1097/GRF.0b013e3181ce0965 provides insight into the
management of pph especially use of oxytocin and other uterotonics.
Roach, M. K., Abramovici, A., & Tita, A. T. (2013). Dose and duration of oxytocin to prevent
postpartum hemorrhage: a review. American journal of Perinatology, 30(07), 523-528.
No pdf to this article. Check the doi DOI: 10.1055/s-0032-1329184
Vincent, J. L., & De Backer, D. (2013). Circulatory shock. New England Journal of
Medicine, 369(18), 1726-1734. The patient was at a risk of developing hypovolemic
shock. This article shows the pathophysiology of shock including the signs of shock. Pdf
provided.