Jennifer Williamson
March 2018
Jennifer
Williamson
,
RN, BSN, RNC-OB
Maternal Newborn Unit
Bassett Army Community Hospital
Fort Wainwright
,
AK
United States
The patient, K, delivered via non-urgent cesarean section for failed induction of labor. She had an uncomplicated cesarean section and was transferred back to the Maternal Newborn Unit to continue her recovery. Although K appeared to be stable, it was discovered that during her recovery that she was internally hemorrhaging, requiring immediate evaluation, treatment and return to the OR for an emergency dilatation and curettage. This finding was a result of the clinical expertise of CPT Jennifer Williamson.
Postpartum hemorrhage is a leading cause of pregnancy-related complications, a life-threatening emergency and a main contributing factor to the current maternal mortality rate. Many elements can put a patient at risk for having a postpartum hemorrhage. A thorough assessment is crucial, as subtle changes can be difficult to detect and can indicate a hemorrhage is well underway.
Early detection of a postpartum hemorrhage takes practice and skill. Through dedication to her practice and her patients, CPT Williamson was able to detect an uncommon variance during her patient's recovery assessment. Although K's assessment was within normal limits, it was concerning to CPT Williamson that the uterus appeared to be too high, above the level of the umbilicus. Immediately following her assessment, she promptly notified the doctor, who quickly confirmed via ultrasound that the patient was internally hemorrhaging. K was rapidly returned to the OR for an emergency D&C. In spite of having an estimated blood loss of 1700ml and receiving 3 units of blood, K had a stable recovery following the procedure, and she was able to bond with her new infant and her family on the Maternal Newborn Unit.
Of interesting note, K had a very uncommon, "pinhole" cervix which did not allow blood to leave the uterus, causing the fundus to feel firm and produce minimal lochia, which are within normal limits of a postpartum assessment. A new nurse may not have caught this hemorrhage until very late considering these factors.
CPT Jennifer Williamson embodies the mission and vision of the Maternal Newborn Unit. She provides high-quality healthcare and uses teamwork to provide the absolute best medical treatment to our patients, contributing to making Bassett Army Community Hospital a High Reliability Organization.
Postpartum hemorrhage is a leading cause of pregnancy-related complications, a life-threatening emergency and a main contributing factor to the current maternal mortality rate. Many elements can put a patient at risk for having a postpartum hemorrhage. A thorough assessment is crucial, as subtle changes can be difficult to detect and can indicate a hemorrhage is well underway.
Early detection of a postpartum hemorrhage takes practice and skill. Through dedication to her practice and her patients, CPT Williamson was able to detect an uncommon variance during her patient's recovery assessment. Although K's assessment was within normal limits, it was concerning to CPT Williamson that the uterus appeared to be too high, above the level of the umbilicus. Immediately following her assessment, she promptly notified the doctor, who quickly confirmed via ultrasound that the patient was internally hemorrhaging. K was rapidly returned to the OR for an emergency D&C. In spite of having an estimated blood loss of 1700ml and receiving 3 units of blood, K had a stable recovery following the procedure, and she was able to bond with her new infant and her family on the Maternal Newborn Unit.
Of interesting note, K had a very uncommon, "pinhole" cervix which did not allow blood to leave the uterus, causing the fundus to feel firm and produce minimal lochia, which are within normal limits of a postpartum assessment. A new nurse may not have caught this hemorrhage until very late considering these factors.
CPT Jennifer Williamson embodies the mission and vision of the Maternal Newborn Unit. She provides high-quality healthcare and uses teamwork to provide the absolute best medical treatment to our patients, contributing to making Bassett Army Community Hospital a High Reliability Organization.