Sunday, March 30, 2008

Unusual delivery

Still on call for the weekend. Josh and I had a lady come in at 27wks pregnant with vaginal bleeding. One of the concerns is placenta previa, but the ultrasound showed the placenta to be up in the fundus. She was stable, so we initially just monitored her and the baby. A few hours later a call came that she was bleeding a lot more, and the baby's heartrate had dropped. I was at the Radcliffe's and so I discussed the situation with Jim prior to heading over. We found a stable mom with good blood pressure and pulse, and the FHTs were actually 120s. So our plan was conservative management. Jim called over, as he often does to check on things, so he recommended a pelvic exam to just see what we were dealing with down below. So I do this and find what I think is the placenta coming out, with mom wanting to push. So then I started to think I was wrong on the US, and she did have a previa and now it is coming out and I am praying she won't bleed to death before we could section her. I left the room quickly to rediscuss with Jim and the nurse calls out that the baby came out. As I walked behind the curtain I found the baby had come out head first, still wrapped in it's membranes with the placenta all as one. Mom had stopped bleeding at this point. We ruptured the membranes, and started working on our premature baby. He started breathing on his own, we transferred him to the nursery and got him warm and gave oxygen and prayed over him and then with mom that all would be well. Mom, Janet, was very thankful and was praising God as we prayed with her. He is very small, so we will just trust the Lord with his life.