Shock is a clinical syndrome in which there is a failure in the regulation of blood

circulation resulting in failure to supplies the metabolic needs of the body. In the
pathophysiology of circulatory shock is a disorder that is defned as a condition of
inadequate oxygen transport to tissues or perfusion caused by hemodynamic
disturbances. Thus shock can occur by a variety of reasons and through a variety
of processes. It can generally be grouped to four components, the degradation of
intravascular plasma volume, cardiac pump problems, problems on both vessels
arteries, veins, arterioles and venules, as well as the potential for good ow
blockage on the heart, pulmonary and systemic circulation. ! woman aged "#
years with a chief complaint impairment of consciousness after undergoing
surgery on indications sectio $esaria severe pre eclampsia. %oss of
consciousness began to appear & " hours before being taken to the hospital, the
patient's family claimed the patient looks limp, appears sleepy and di(cult to
communicate. )atients had undergone previous surgery labor with Sectio
$aesaria & * hours before refer to hospital !hmad +ani in ,etro. In addition,
patients also complain of shortness of breath, abdomen feels full and getting
bigger. )atients could receive treatment at the -ospital in .ay /epara but due to
the patient's condition worsened the patient was referred to !hmad +ani ,etro
-ospital for intensive care in the I$0. 1ased on physical examination found the
general condition is severely ill, apathetic consciousness, 2$S scores 34, blood
pressure #4564 mm-g, pulse7 384x 5 min regular, less contents and weak stress,
breathing "8 times per minute, temperature "6 , 9:$, $;T lengthwise. <ound
con=unctival pallor on the face, nasal aring and central cyanosis. >n pulmonary
examination found a decrease in vesicular sound on the left lung wet ronkhi fne
?@A on both basal pulmonary >n abdominal examination, look convex and found
tenderness in the right upper quadrant, shifting dullnes ?@A. !t the superior and
inferior extremities felt cold akral. In laboratory tests showed -b 9.B g 5 dl,
hematocrit 88.8C, leukocytes 39,644 mm ", platelets 8"B,444 mm",
erythrocytes 8.9 million 5 mm". In blood chemistry didaapatkan !ST ?S2>TA 3# 0
5 %, alanine aminotransferase ?!%TA 34 0 5 %, urea 3*.* mg 5 dl, creatinine 4.#" mg
5 dl, blood sugar when 38B mg 5 dl. In a complete urine examination showed faint
1lood ?@@A, ketones ?@@@A.
;adiological examination of xDrays on the !) found cardiomegali and pulmonary
edema, whereas the abdomen sonogram picture !scites was found in the pelvic
cavity ?fossa illiaca dextraA splenorenalis fossa. The diagnosis of hypovolemia
shock patients ec suspect intraDabdominal bleeding post op Sectio $esaria.
Therapy given to patients with the administration of intravenous uids ;inger's
lactate 644 cc and 644cc <imahes and continued to maintain per # hour
monitoring of urine output as well as the provision of >8 lid "D6% 5 min, 34 meq
Eobutamine In=ection, In=. Eexametason 6mg, 84mg %asix In= 5 8* hours,
>xytocin In=ection 34 I0 5 # h and 8 Folf );$ transfusion. -ypovolemic shock that
occurs in these patients due to the presence of bleeding, therefore it takes it
takes a quick and accurate diagnosis and appropriate management of the
condition to improve and prevent further complications.