Conservative Treatment of Puerpera with Severe Hemorrhagic Shock and Secondary Coagulopathy

Abstract

Abstract Aim: The main aim is to show that the life of a patient depends on the decisions the doctor makes as well as the proper assessment of the case. The decision to avoid a surgical procedure and continuewith the conservative treatment following the vital parameters, was beneficial for the patient who was later discharged recovered. Case report: The case is about a patient who was in labor for the fifth time with the delivery complicated by severe postpartum hemorrhage in the secondary health care institution. Despite all conservative measures taken, the hemorrhage hasn’t stopped, therefore, the subtotal hysterectomy was performed, after which the patient was directed to the Clinical Centre Kragujevac. Regarding the fact that the postpartum hemorrhage hasn’t stopped and abdominal hematoma as well as intracranial hemorrhagewere diagnosed, the main dilemma was if the surgical procedure should be redone or if the conservative treatment should be continued. By applying the conservative treatment andcontinued consultations of the multidisciplinary team, the patient was discharged from the Clinical Centre Kragujevac. Conclusion: The main issue with severe cases like this one, is to define and direct the treatment towards the lower risk rate – repeated surgery could be fatal with the current state of the patient. The estimation was correct, at the end, the patient was released after the-lengthy treatment, recovered.