Case report: nursing care of postpartum hemorrhage complicated by postpartum heart failure

This study retrospectively analyzes the clinical nursing of a patient with postpartum hemorrhage complicated by postpartum heart failure, exploring nursing strategies for such cases. In addition, it introduces care methods based on the Enhanced Recovery After Surgery (ERAS) concept, focusing on psychological support and the recovery of postpartum physical function. The patient underwent forceps-assisted vaginal delivery due to acute fetal intrauterine distress and delivered a female infant. Postpartum hemorrhage of 1,000 mL occurred. At 1 hour and 38 minutes postpartum, the patient suddenly experienced chest tightness, choking, dyspnea, and coughing without pink frothy sputum. A multidisciplinary emergency response was immediately initiated. Within 2 hours postpartum, the patient developed heart failure, likely related to the administration of uterotonic and vasoconstrictive hemostatic agents and rapid intravenous fluid infusion, which increased cardiac load and triggered heart failure. Following meticulous treatment and nursing care, the patient recovered and was discharged. With adherence to a series of guided interventions, her postpartum physical functions achieved satisfactory rehabilitation.