P₂A₀ 38-year-old Woman Postpartum Hemorrhage with Hemorrhagic Shock and Severe Anemia Caused by Uterine Atony: A Case Report from Southwest Sumba, East Nusa Tenggara

Postpartum hemorrhage is one of the most common obstetric emergencies and the largest contributor to maternal mortality in the world, with uterine atony being the most common cause. A 38-year-old woman came to Karitas Hospital complaining of vaginal bleeding after giving birth three hours ago. On examination, the patient was somnolent with signs of shock. Anemic conjunctiva, pale lips, weak contractions of the uterus, and active vaginal bleeding. The laboratory results show severe anemia and leukocytosis. The diagnosis was P2A0 38-year-old woman, postpartum spontaneously with hemorrhagic postpartum caused by uterine atony with hemorrhagic shock and severe anemia. The treatment was given according to the algorithm for managing postpartum hemorrhage. Uterine atony is caused by many factors, one of which is precipitous labor as experienced by the patient. Fluid rescucitation, uterotonics, uterine massage, bimanual compression, and the insertion of a condom catheter were given because there was still active bleeding after the 3rd stage of active management. Finally, surgical intervention should’ve been taken as the last step to stop the bleeding. Fast and precise handling can prevent complications of postpartum hemorrhage, namely shock and death.