HealthMedicine

Hemorrhagic shock in obstetrics and gynecology

When a body loses more than one liter of blood, a person develops a hemorrhagic shock. If the bleeding is not stopped in time and continues on, then with a loss of about thirty percent of the volume of circulating blood, this condition poses a threat to life.

The blood loss can be either visible or invisible. With open trauma to the eye, doctors can determine the amount of blood lost and the severity of the situation. After a significant loss of it, a hemorrhagic shock develops in a person. This is a special response state of the body to a threatening situation. For example, hemorrhagic shock in obstetrics and gynecology is one of the most dangerous, as there is latent bleeding, and if you do not provide timely medical assistance a woman may die. Most often this leads to apoplexy of the ovary, trauma of the genital organs, frozen pregnancy, submucous uterine myoma, perforation of the uterus body, bladder skeleton, consequences of abortions.

The main threat in such situations is the disproportion of the capacity of the vascular bed and blood circulating there, or rather, its remainder. This leads to a violation of macrocirculation - blood circulation along arteries, veins and in the heart. The next stage is the violation of microcirculation - along arterioles, venules and capillaries.

If you lose about half a liter of blood, then the body can compensate for this by increasing venous tone. At the same time, the arterial tone does not suffer, the heart rate does not change, the tissue supply fails.

Significant hypovolemia leads to a serious stressful condition. In order to maintain life, the body includes powerful compensatory mechanisms. Increases the tone of the nervous system, increases the release of hormones. Under their action, the heart rate increases, the elimination of fluid from the body is reduced, there is a spasm of the vessels along the periphery. However, such changes in the body only temporarily support his life. Later, if the condition worsens, such mechanisms fail, and oxygen starvation of organs and tissues occurs.

Hemorrhagic shock can be of three stages, the classification of which is based on the volume of lost blood and disorders in the work of organs due to this loss. At the first stage - compensated, the affected pale, the veins on the hands are sunken, slightly pulsating, tachycardia appears. The volume of lost blood is up to one liter. In case the bleeding is stopped, the symptomatology may still persist for some time. If the bleeding continues, the symptomatology is aggravated - this condition is called decompensated reversible. That is, the body itself can not cope with such violations, but the medical help provided in time, saves the woman. In the second stage, the heart, lungs, brain, liver and kidneys suffer, severe hypoxia develops. The last stage is irreversible hemorrhagic shock. The loss of blood is about half the total volume that circulates in the body. In this case, even the reanimation measures may not help.

Diagnosed hemorrhagic shock based on indicators such as temperature and skin color (special attention is paid to the limbs), blood pressure, shock index, hematocrit, hourly diuresis.

Emergency care for hemorrhagic shock, provided on time, is the key to success in removing this condition. In the field of gynecology, the first measures should be aimed at accessing the place where bleeding occurs. Here urgent surgical intervention is required. Simultaneously with the surgeon and gynecologist, an anesthesiologist is also working. When the bleeding stops, you need to remove the patient as soon as possible from the condition of hemorrhagic shock.

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