Hypovolemic Shock

Abstract

A healthy 25-year-old woman, G1P0, had been admitted to Labor & Delivery with these vital signs: blood pressure 134/83, pulse 74, respirations 16, temperature 98.3 F, weight 71 kg, and height 1.70 m. Her hematocrit was 33 and her other blood studies were unremarkable. The patient had had an uncomplicated pregnancy and after a lengthy induction of labor she delivered a healthy infant at 13:07 without labor analgesia. Estimated blood loss at delivery was 600 mL, with 150 mL of clot being delivered some 10–15 minutes later. Soon after delivery, the patient became pale, confused, and then somnolent, with a blood pressure of 84/50, pulse 80, and an oral temperature of 101.4 F (L-1). The obstetric team was dealing with continued vaginal bleeding of uncertain origin and had already increased the oxytocin infusion rate and administered methylergonovine and carboprost intramuscularly to treat possible uterine atony (L-2). They now call the anesthesia team to help with resuscitation.