Can you relate the situation of the

Can you relate the situation of the mother in the postpartum period? Narda a 29-year-old primigravida with an expected date of delivery on 10th October,2022 presented to the labor and delivery unit on 1st October 2022 with a complaint of contractions for 6 hours which were occurring at intervals of 2 minutes and lasting for 60 seconds each. There were no complaints of dribbling, however, the show was present. On examination, her cervix was 9cm dilated and almost fully effaced and temperature, pulse, respiration, and blood pressure were all normal. Since epidural anesthesia was not wanted by the mother, meperidine and promethazine were given while continuous monitoring of fetal heart rate and contractions are done by an electronic fetal monitor which was reassuring with occasional accelerations. She delivered a 2200 gm healthy baby boy with an APGAR score of 8 after 1 minute and 9 after 5 minutes by NSVD with a mediolateral episiotomy at 6 am. Skin-to-skin contact with breastfeeding was initiated and the placenta was delivered within 10 minutes by the Schultz mechanism. She was observed for 2 hours in the recovery room and all her vitals were normal, the uterus was well contracted and at the level of umbilicus with moderate lochia. Following this, she was shifted to the postpartum unit. 6 hours after delivery, she was seen to have postpartum hemorrhage. Immediately, IVF with 20 units of oxytocin, blood requisition and foley’s catheterization was done. The postpartum hemorrhage was thus managed by removing retained products of the placenta and giving carboprost. Blood investigations showed low hemoglobin and red blood cell count. After this complication, some time was needed for her to recover, both emotionally and physically. On the second day, she had a bit of pain on our episiotomy site which was seen to be red with a bit of seropurulent discharge and moderate lochia rubra. She was given analgesic, stool softener, and sitz bath with a high Fibre diet. All concerns about breastfeeding were addressed and on examination, her breasts appeared to be normal. After 5 days, she was discharged in a hemodynamically stable condition with antibiotics, analgesics, and ferrous sulfate tablets with an order to come back to OPD after a week with CBC report. Her baby was kept at the hospital for treatment of neonatal sepsis.

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