Wednesday, May 20, 2015

Doctor come, the baby's head is stuck...


Today is Wednesday.
We have Antenatal Clinic or ANC. People love acronyms here.
We had just finished seeing 40(!!!!!!!!!!!!!!) pregnant women when the nursing assistant from the Labor and Delivery came and very calmly states, "Doctor you come, Berna the midwife said you come. " So I ask, is it an emergency?
She answers very calmly, "A patient arrived from Nandi (a neighboring town) her baby's head is in the vagina."
What???
Is the shoulder stuck?
No. They can't get out the baby since yesterday.
What the HECK??????!!!!!!!!!
This conversation is happening while we are walking rapidly to the Maternity Ward.
A very dehydrated, lady is laying on a regular bed in Postpartum. Indeed a baby's head is coming out of her vagina.
So I immediately get the lady to the Delivery Room.
OK, the shoulders are not "stuck".
They are actually being pulled back if anything.
No fetal heart tones. (Dead baby of course).
But the women has severe abdominal pain., I can feel a leg very high up like right against the abdominal wall.
She must have a  Uterine rupture.
I say loudly and firmly, We need to go to the Operating Theater.
When we open the lady up, OMG!!!!!!
She has a huge uterine rupture. The uterus is exploded open.
Then WHAT????
CONJOINED TWINS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Thoracopegus. Joined at the chest.
This poor woman was trying to push out for 12 hours or more the impossible. They would have NEVER come out from below.
She would have eventually died.
Thank God she came. We can try to save her.
The infants delivered easily actually once we grabbed all 4 legs and arms.
Then we repaired the uterus.
I am shocked this lady did not die when she ruptured considering that her uterus exploded open through the side.
She just missed the vessels of the right side of her uterus.
We were able to save the uterus.
Now the strange part is that when the nurse brought the babies outside, the father ran off because he was scared. (So I am told, as I was still in the OR)
Then the aunt took the babies and placed them on a mat. Then everyone proceeded to call everyone they know and by the time I came out of the OR there were at least 150 people all around the babies. Looking, taking pictures. Calling more people.
I asked the "Theater Attendant" if we should bring the babies inside, and not let them be a "display". He said, No the family and the people want to see.
OK.
Then one of the Local midwives asked me if we have this type of "birth" in my "village". I told her that conjoined twins happen everywhere and in my "city" they also happen unfortunately. But usually we know about it early on because of early ultrasound.
So she asked me, "It is not satanic then?"
I responded, " NO of course not!!!! NEVER!!!!! It is just a simple issue of when the embryo separates. Pure science." "No Satan".
In fact we should thank God that this mother is alive.
PRAISE BE JESUS CHRIST NOW AND FOREVER!!!!!!!!!!!!!!!!!!!
What a day!!!!!



1 comment:

  1. My goodness. What a powerful message-- No, it's not satanic, it's just science. And Rachael, from a surgical perspective-- great work, my friend!! Way to manage a massive uterine rupture with a headlamp & no bloodbank! One life saved. Nice job.

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