I have 3 kids....have a ???

KMP77 · May 26, 2007

LOL. I remember this with my 1st too (10 years ago) I was young and he was my first. I had no clue what was normal or not. I got out of bed to use the bathroom and when I stood up blood gushed out of me, and it looked like a LOT, a lot of the floor was covered in it. WELL the nurse that was with me RUNS OUT OF THE ROOM!!! Here I am, 19 years old not knowing what the hell is going on. My Mom and now hubby was with me and turned pale as anything. Nurse comes back and apologizes, she was new and didnt know if that was normal. She says it was but nobody came to check?! I was also told with that delivery, I had a hematoma (sp?) which still today I have no clue what that is??? Nothing was done about it. The ob checked it and kept an eye on it but nothing was done.

preciousbaby621 · May 26, 2007

That sounds odd. Nurses will usually stay with you through out the whole process. They will monitor the baby and check your cervix for dilation/ effacement. Maybe your pregnancy was complicated, that it required a doctor to check your cervix. I have 2 kids, and I only saw the doctor when it was time to push. The nurse did ALL the work.

KMP77 · May 26, 2007

No complications, not that I knew of anyway LOL. The nurses were always with me, but I remember them saying they werent allowed to check? I should have asked why.

SmilingBluEyes · May 26, 2007

In some places, only residents/ other doctors do this. Esp in teaching hospitals. That could be why. In most other hospitals, nurses do this as well as much more.

HappyNurse2005, RN · May 27, 2007

well,its half and half where i work. (teaching hospital)

we have residents and we have private physicians. if it is the patient of a private physician, the nurses can and do check. unless the doc specifically says he/she is coming back to check at a certain time.

the residents we have staff the local clinic(mainly medicaid/no insurance/etc) or pt's who have no doctor, and transfers in from other facilities. they do NOT see every patient. the residents prefer to do their own vag exams b/c they need the practice. they come and check approx q2h unless we ask them to come sooner r/t a problem/complaint of pressure, etc etc. though, if the situation is urgent, i will check them. (like the unmed g6p5 screaming she has to push)

KloesMama · May 27, 2007

kmp77 a hematoma is a bruise. lol

KellNY, RN · May 28, 2007

kmp77 a hematoma is a bruise. lol

Not always the case. We just took a 16y/o to teh OR to excise a labial hematoma....poor thing had a totally drug free L&D, but got an epidural for this. It was about the size of half an orange. (in ob,a hematoma is usally when the blood pools to a more severe degree and can cause swelling and terrible pain. Not just a bruise)

To the OP-That was probably the case (what SBE said). In my hospital--also a teaching--the residents do all the checks, that goes for private pts too. Most of our nurses unfortunately wouldn't know a 2cm from a 4cm or a 4 from a 6, or a 25% from a 75% yk? So in that case it's better that the Rn doesn't check you.

Elvish, BSN, DNP, RN, NP · May 29, 2007

We had a pt once whose hematoma ruptured & she subsequently got like 6 units of blood :eek: from the bleeding that ensued. I don't know if she had any other underlying pathology, but it was a really scary case.

KMP77 · May 29, 2007

Mine was pretty big but my ob said he didnt want to do anything yet, just keep an eye on it. Im assuming it went away?! LOL.

mitchsmom · May 29, 2007

Mine was pretty big but my ob said he didnt want to do anything yet, just keep an eye on it. Im assuming it went away?! LOL.

Yes, the blood just reasbsorbed.

Here's one little thing I found on hematomas as they apply to obstetrics for you:

Hematoma is an asymmetrical and painful swelling of the perineal area. It is usually caused by soft tissue trauma in second stage, or by a faulty repair job, whereby hemostasis has not been achieved, i.e., bleeding vessels continue to seep below the skin or mucosal surfaces. Although these hemorrhages almost always cease spontaneously, the blood takes time to reabsorb. Pooled blood readily permits the growth of bacteria, thus the primary danger of hematoma is infection. This can lead to breakdown of the repair, because once sepsis develops, surfaces will not adhere and close properly. Traction on the sutures from swelling is another factor in repairs breaking open or rupturing.

Immediately refer any woman with signs of hematoma to a health care provider; she should begin antibiotics as soon as possible. To reduce swelling, have her alternate hot and cold soaks, which stimulate circulation and encourage reabsorption of the hemorrhage. Also make sure the mother pours warm water with a bit of Betadine over her lady partsl area each time she uses the toilet, and remind her to dry and air her perineum thoroughly afterwards. If the repair does break down, plastic surgery may be necessary. The midwife and mother should do their best to prevent this!

SmilingBluEyes · May 30, 2007

Excellent post, thanks, Mitchsmom!