20 minutes to live....

The day before yesterday as I was seeing Gynecology patients in the "office", the Midwife Bernadette called me. Shes states that a patient was brought in, carried by her relatives. She stated that a patient that I had seen earlier today was sick.
This patient came to the office earlier that day with a + pregnancy test. Here we do not have the capacity for a Quantified HCG. But on ultrasound there are no POC (products of conception) in the uterus. I was worried about an ectopic pregnancy, but the Fallopian tubes were normal appearing the ovaries appeared normal. The pt had no pain and was stable. No vaginal bleeding. the uterus appeared a little enlarged but not anything that at that time appeared worrisome. So I recommended close follow up and for her to return the next day and THANK GOD I put on the paper, return sooner if sick. (not that there is any legal ramifications here from any documentation, but for my peace of mind)
Well, when I go to see the patient she is hypotensive, tachycardic, pale and has severe abdominal pain. So when I placed the ultrasound machine on her pelvis, there is an abdomen full of blood!!!!
I explained to everyone present that we need to go to the Operating Theater right NOW. But typical response, no fast movements, so I said in a loud and deep voice.
" If this patient is not in the Operating Theater in the next few minutes she will die! She has 20 minutes to live!".
So I got a fast response and everyone amazingly worked super fast and hard, and she really was in the O.R. quickly.
When I made my incision, mid-line I could see purple under the peritoneum. The abdomen was full of blood. The blood was just pouring!!! The ectopic pregnancy had ruptured!.
It was an ectopic in the cornual region of the uterus which is so bad because it is difficult to detect, difficult to remove and to fix.
I grabbed packing and quickly packed her abdomen. I could not see anything because of the literal fountain pouring out of her. So I used my hands to grasp the uterus and followed down the tubes and felt the rupture on the right side.
I squeezed it closed and the blood stopped!! Thank God!!! Then I placed the clamps, no bleeding!
Then I performed the surgery to fix it. Of course this place is part of the uterus so unlike the tube we can't remove it.
The patient today is doing well postoperatively.
Today Saturday I was called back to the hospital, a mother had been brought in bleeding after a spontaneous abortion this morning. She was at home bleeding for 12 hours. On ultrasound she had a piece of placenta in her uterus still. By the way I am the one performing all the ultrasounds. With my hand held ultrasound. Thank you CMMB. We performed a STAT D&C and now she is doing well. This was her 11th pregnancy.
Because of the polygamy the older wives are trying to keep up with the younger wives, so they keep getting pregnant when the younger newer wives get pregnant. Not really an ideal situation.
Life here is so fun!!!!
The people are very friendly,
The food is great.
The Church is exciting, vivacious and ALIVE!!!!
Praise to you Lord Jesus Christ!!!