Hypovolemic Shock

[SpeckledFrog2014]

I'm currently writing an email to the PALS office of the hospital I gave birth in and want to question how they dealt with my bleed. I went on some first aid training today and almost had to leave the room as I felt sick to my stomach and very tearful as when we got onto shock I now clearly understand I went into hypovolemic shock! Which is shock from lack of fluid in your system for those who don't know, I only learnt today too. I quite clearly remember the midwife writing 450ml as my blood loss and I had drunk so much water before I had given birth that I filled one and a half bed pans when I did have a wee. My understanding was that 450ml is on the higher side of normal, but nothing to worry about. Could there be a mistake on the amount or is it possible to go into shock from this amount of blood?

One bag of fluid was administered to me and another was shoved in carelessly and was not monitored and ultimately just puffed up my hand and did nothing. I was not right for a very long time and experienced dizziness for a week or so after. Does anyone know if I should have been given drugs? I was on a machine, but it was irregularly monitored and I had also closed the curtain and forgot to open it before getting back into bed on the ward I could have easily passed out and even dropped my baby without anyone realising. At the time I was clueless about shock and the like and have for 8 months naively thought every one had the same experience as me. I also bled very heavily after and kept bleeding all over the place when I stood up.

[MrsPatrickDempsey]

Hi
I think it would be really helpful for you to arrange a debrief as it is quite hard to fully establish what went on from your account. A 500 ml blood loss is classed as a PPH. Blood lossed at delivered is estimated and this is sometimes inaccurate but because you have a greater circulating blood volume at the end of pregnancy I think it is unlikely to have hypovolaemic shock from this amount of blood loss. You may have been anaemic from the sound of your symptoms. The drip may have had a drug called syntocinon in it which contracts the uterus..... cant tell but do seek clarification.

[breakfastinbread]

Hi,

That amount of blood loss falls into the range of normal. A woman develops a higher blood volume in pregancy partly to cope with losing blood during delivery. To put it into perspective, 450mls is about the amount of blood given at blood donation, but it is still normal to feel dizzy after that. I lost 800mls for example and wasn't in shock afterwards. The fact you were able to pass so much urine is a good thing. Were you anaemic in pregancy? Did you need iron tablets at any point?

A major haemorrhage would be classed as over 1-1.5l.

It does sound like your concerns weren't addressed, and perhaps you needed some explanation at the time, so I echo the PP that perhaps you need a debrief?

[SpeckledFrog2014]

I didn't think the bleed was very big at all myself, so I'm really confused by what happened to me. That's way I was wondering whether they had missed additional bleeding. When I did stand up the blood was everywhere, pad, knickers soaked through, all down my legs and all over the floor.

Just to clarify the story as I didn't explain oops. I didn't have a traumatic time in labour or anything and found it fairly "easy" although I did have an episiotomy. It was an hour after I had been stitched up and I started sweating profusely, my ears started ringing and white specks where filing up my vision. I had enough sense to tell my husband to take our baby and then I just went. The emergency button was pressed and when I came around the people that weren't needed were just leaving the room. I then had a weak pulse, it being high and my blood pressure low. I had given birth early hours of the day and still couldn't move any more upright than a slouch by the evening without feeling as though I was going to faint.

I wasn't anaemic during pregnancy and had a very healthy pregnancy. I had high something of the other, I don't know what, that the staff were really impressed with and had asked me what I'd been eating, so I don't know whether that was something that is good when not giving birth, but bad after birth. To be honest this bit of my experience of the hospital in comparison to everything else is like a stubbed toe verses a broken leg. It was pretty bad there!

[SpeckledFrog2014]

Also had a weak pulse by the following evening when I left. They discharged me for the bed as it was cattle market like in there.

[SpeckledFrog2014]

Also also after I'd given birth the midwives saw no problem with m going home as soon as possible and I felt fine and honestly wondered what the fuss about childbirth was, so it was definitely not the stree of giving birth too. I was classed as low risk and went into the midwife led section

[Boysclothes]

Honestly it sounds much more like a vasovagal. en.m.wikipedia.org/wiki/Vasovagal_response

Hypovolaemic shock is very very serious, rare, they would have been working on you a long time and then admitted you to an HDU ward or similar. And they are not caused by 450ml blood losses.... more like three litres.

I've had a vasovagal about an hour after having a coil inserted. It felt absolutely horrible and although I knew what it was, so knew I wasn't dying, it felt like I was! So you totally have my sympathy. Definitely look into a birth afterthoughts or birth debrief session x

[SpeckledFrog2014]

Sounds like it but there are some discrepancies such as high heart rate instead of low and feeling bad for a week later rather than just hours. I will definitely have to have a debrief me thinks. I really hope it is actually what you say Boys as I would like to have a home birth with my next. That's if I can actually even regain the ability to do the act. A nerve was severed with my episiotomy too, but it has only been eight months, so I'll leave it for a year and see what's what then