A fall followed by red-that’s danger sign
Kay* was brought into the labour ward hauling in pain. Aroused by the desperate screams, I rose from my chair in the nurse’s station and made my way to the entrance of the ward where the receiving nurse was trying in vain to calm a hysterical Kay.
Her husband who had also accompanied her to the ward was anxious and frantic as he shouted, ‘Can somebody help my wife and baby? Can we go to theatre now?’
As it were, Kay had slipped and fallen on the stairs of her apartment building as she hurriedly rushed home from work. Like most pregnant women, she had forgotten that she was pregnant and while quickly climbing the stairs to her flat, she missed a step, slipped and landed her on her tummy. A gush of pain followed and her abdomen became tender as blood started fusing out and she frantically called out to her neighbour. On arrival, he hurriedly contacted her husband who came immediately and dashed her to the hospital.
Luckily for the couple, Kay’s husband had called their doctor on the way to hospital, who arrived just in the nick of time to calm the distraught duo, assuring them that all would be done to save both mother and baby.
As soon as the couple was put to rest, mum was wheeled into an emergency room and put on a continuous monitor. The heart rate was measured 136-143 beats per minute and an intravenous cannula was inserted to start Kay on intravenous fluids. Meanwhile, the theatre team was getting ready for an emergency caesarean section. The doctor (obstetrician) had also called the anaesthetist and the paediatrician who arrived quickly and measured Kay’s vital observations as normal with a blood pressure of 100/50 and a pulse of 76 beats per minute. Blood was also drawn from Kay for grouping and cross matching of 2 units of blood in case there was need to transfuse post-operatively.
Kay was finally wheeled into the theatre with a fetal heart rate of 128-139 beats per minute. She was still bleeding and the pain remained persistent. I accompanied her to the theatre as the receiving mid-wife and operation commenced. Within 2-3 minutes, a robust baby boy had been extracted and he said hallo to the world with a loud cry, announcing, ’I am here, alive and healthy!’
Needless to say. everybody released a sigh of relief at the shrill cry of baby *Joey. A lot of blood clots were also removed from Kay’s uterine cavity and the placenta was found to be completely separated—placenta abruption. This is what was causing the profuse bleeding. On examining the uterus, it was found to have ruptured and the damage was beyond repair. By then, Kay was still bleeding and had 2 units of blood transfused in the operating theatre as the damaged uterus was removed (hysterectomy) Her blood pressure dipped further to 90 / 40 and more blood was transfused. She was then transferred to the high dependency-unit where further transfusion was done.
She recovered well and on day two she was transferred to the ward. Kay was grateful to be alive and for the team that saved her precious baby boy. Even though she lost her uterus, she was happy to be alive—glad she had been brought to the hospital immediately.
She commends the medical team for moving in swiftly to save her and her baby boy. She urges other women, ‘Pregnancy is a precious time and nothing should be taker for granted, even the least of instincts should be honoured by any pregnant woman.’
Ante partum hemorrhage is when a pregnant woman starts to bleed after 28 weeks of gestation. This can be as a result of many factor e.g. a fall, shock, domestic violence or a sudden bang e.g. when applying emergency breaks while driving. This leads to premature/abrupt separation of part of the placenta which is normally attached to the uterus and causes bleeding which requires urgent attention depending on the amount of blond Inst and the maturity of the baby. If quick actions and measures are applied, most babies and mothers can be saved. In few cases, the baby dies and the mother suffers from hypovolumic shock which usually requires intensive care and close monitoring. When this happens, it is usually very devastating to the midwife and the medical team involved and it’s usually not a happy ending as is evident in Kay s case.
* Not their real names
END: PG35/13