Thursday, February 26, 2009

desperate times call for desperate measures

This entry is meant to detail some of the events that took place with no intention of highlighting or diminishing any deficiencies/special advantages of the situation.
Also, in light of the very 'medical' nature of this entry it is understandable that those with no background in the medical field will find it difficult to empathise much less comprehend some of the issues pertaining to the index circumstance and as such any comments or opinions from such parties should be considered with that in mind.

so i was oncall again since yesterday night (which i hate to be, to be frank, but that doesn't mean that i do not give my best when it comes to patients and all... it's just... well, if you were oncall you would understand).

And at approximately 6am this morning i get a phone call from a very nervous-sounding nurse in the labour room..

from what was said on the telephone (which i shan't go into much technical detail), this were some of the anticipated problems:

1. A woman who's very well into her labour by the time she came to the hospital was unaware that her baby was in breech presentation.

Breech presentation to put it simply means that instead of the normal position of the baby's head being at the bottom (i.e. the first part of the baby's body to be delivered), it was the baby's butt.

2. Moderate meconium liquor.

Again, without dabbling too much with the details basically it is a sign of possible fetal distress or asphyxiation (i am oversimplifying... to learn more please read up from a trustworthy source).

3. CTG showing fetal tachycardia and Type 1 decelerations.

Basically, another 'not very good' sign with regards to the baby's overall status.

i rushed to the labour room with plans to arrange for an emergency lower segment Cesarean section.

anyway, cut the long story short while in the midst of arranging it the baby couldn't 'wait'!

And so, i was 'forced' to conduct my first ever breech vaginal delivery!
And without any obstetrician (specialist) around at that!
Not even the obstetrics and gynaecology medical officer (who was on the way but not there yet)!

See, in this day and age this sort of thing is hardly done because usually once a pregnancy has been confirmed to be breech presentation during follow-up, the plan would be to arrange for a C-section somewhere close to the time of delivery or rather when the pregnancy approaches 'term' meaning that the baby is mature enough. Such arrangements are made because it is deemed far safer for the baby and mother to undergo surgery... i.e. breech vaginal delivery carries with it more risks!


i prayed silently as i steeled myself to do what i had only learnt years ago in theory.

Thank God for wisdom and grace because everything went smoothly and the baby was delivered safe and sound!
The mother was fine too!

*vinod wipes the sweat from his forehead even now as he recollects the whole episode*

while, to be honest, this was probably one of those 'once-in-a-lifetime' experiences... i really do pray it only happens this once in my lifetime ;)


Joel Vijay said...

awesome stuff - 'once in a lifetime' is just about enough eh? Oh, the next time I bump into grown-up brats, I'll question their delivery presentation. Frank breech? Thanks for the tip! =P

Dr V said...

hahaha ;)
well, it's worth knowing although i'm not entirely sure if it has any bearing on the person's personality ;)