Postpartum Loss in ICU

[nay537]

I work in a medical/surgical ICU and we take care of postpartum patients on occasion. A few weeks ago I had a 28 year old woman who had an emergency c-section at 32 weeks. The next day she started to hemorrhage and had a total hysterctomy. She came to our ICU vented postop. The pulmonologist determined that she was in ARDS so we had her sedated and on a paralytic. They also thought she might be septic and started her on Xigris which was stopped after 48 hours because of decreased pulse ox and the potential need for a chest tube. On day 10 postup she started to desat and brady down. Her heart rate went from 120s to 40s in less than 3 minutes. During our 55 minute code he had a tension pneumo and chest tube was inserted we gave her every med in our code cart and tried everything anyone present could think of. In the end we did everything we could but it didn't make it easy when the husband came in and learned that his wife of 12 months had died and now his 12 day old daughter has no mother. We are having a grief session this week with the hospital chaplin. My only saving grace was that the event occured on a week day and I had social workers, case mangers, and clergy readily available. In the end I cried my whole way home and I'm still shaking now as I type this. THaks for listening.

[BRANDY LPN]

I can not imagine what you are going through yourself and as a unit, please take advatage of any greif counseling offered by your hospital and if they dont offer any find some for yourself, remember that you did everything you could and that youu are in no way at fault for this horrible tragedy. Also remember that you can always come hear to vent. My thoughts are with you.

[zambezi, BSN, RN]

Our ICU went though this fairly recently as well. I think that seeing something like this is one of the hardest things...it is supposed to be such a happy time. I can't even imagine what that must be like for the family. I hope that all is well in your unit--I am sure that you did all that you could.

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[zcubed]

We have so many women on our site who have gotten ARDS in such similar circumstances; I receive so many phone calls or posts on our message board from husbands, parents and most of the stories that are posted on our site are the ones with favorable outcomes, but I know when I never hear from the husbands/parents after supporting them, that their wife/daughter did not survive.

I know that the nurses/physicians involved in such cases, it is incredible difficult and my thoughts and prayers are with you. I always tell families that it is almost as difficult on the medical professionals in these situations as it is for the families...

I have often wondered why so many pregnant woman are getting ARDS, but there are so many other ARDS studies that need to be done that this would certainly not be high on anyone's list.

Thank you for caring so much. Eileen

[gwenith, BSN, RN]

It is always difficult to lose a young healthy mother and we just do not expect it. I think that is the worst bit - the thought that a young mother should not die - we know intellectually that there is still a risk associated with childbirth but you neve ever expect to have to deal with that statistic on a personal a tragic level.

[Elenaster]

As ICU nurses, we are too often witnesses to abject tragedy when young lives are lost despite our best efforts to save them. In this year alone, we've lost two 32 yr-old females, one who went into DIC and had a massive ICH, another with a 3-month old that had a brainstem clot and we had withdraw care. Looking into the faces of their husbands was completely heart-wrenching. I'm usually quite stoic at work, but when the DIC patient was crashing, it was like a domino effect with tears. We were all sobbing before it was over with.

The worst case at my hospital recently was a 30-something woman who had a easy SVD with her last child at an outside hospital. She opted for a laproscopic tubal ligation after the birth and a week later had severe abdominal pain. The OSH wrote it off as constipation and sent her home with laxatives and colace. After she collapsed, they sent her up to us and she had severe perotonitis, sepsis, and subsequently developed ARDS. Turns out her bowels were "nicked" in several places from the tubal and no one had the OSH had enough sense to pick up on it. She later died on ECMO down in the MICU.

[WalkingInTheRain]

That's so sad. I'm hope that her family and everyone affected by the situation can heal. You can only do so much, you can only try your hardest when you've done that then their is nothing really else that you can do. You all tried your best, stay strong and keep your head held high. Just hang in there :)

[imenid37]

That's so sad. We had a mom about 3 weeks ago who was 33 weeks and had an eclamptic seizure at home. She had a stat C/S and sufferred a mild CVA. She was also on the vent, but doing well now. 3.5 LB'er went home Monday. I feel so lucky after reading your story. The family is in my prayers, but the nurses too! This is so tough for you. Take care.

[nay537]

I want to thank everyone for your wonderful words of support, your thoughts, and your prayers in response to this post.