Sangape twins

 A health center was calling on the radio.  They had a women who delivered a baby, but they didn't know if there was a 2nd baby inside.  As they were talking, I was trying to think how over a radio I can determine if there is a 2nd twin inside.  I asked if they had delivered the placenta - it seemed like they said yes.  I asked if they heard a heartbeat - they didn't.  I asked if the uterus was above the belly button - they seemed to tell me no.  So best I could tell, it didn't seem like this mom had a 2nd baby inside.  The health center seemed okay with that and we ended our radio call.   

The next day I was finishing up doing a D&C in the delivery room when a women was carried into the delivery room.  I asked what the story was, and they said it was a lady from a remote health center who was just flown in by MAF, who had a 2nd twin inside.  Right away I knew it was the mom they called about yesterday. 

As soon as I looked at the mom, I knew she had a 2nd twin inside, her uterus was way above her belly button.  I quickly looked to see if the baby was still alive, and we found a heartbeat.  When I checked her, I found that the placenta of the first baby was also still inside.  The heartbeat of the baby inside was very fast, and mom looked pretty sick.  I knew she wasn't going to deliver that 2nd baby anytime soon, so we prepared to do a C/section.  

As we were getting mom ready for the section, I was told the 1st baby was in the ER, so I went to check on her.  The 1st twin was really sick.  She was very small at 1500gms, cold, and wasn't breathing very well, I wasn't sure she was going to make it.  I took her to the nursery, where we warmed her, gave her antibiotics and had to breathe for her.  I wasn't sure she was going to make it, so I stayed at her bassinet resuscitating her, while Jim volunteered to do the C-section.

Once she looked a little pinker, and was warmer, I went to the C-section to see if the 2nd twin needed help since the heartbeat was so fast.  Thankfully the 2nd twin was bigger, and came out crying.  He pinked up right away and looked really good.  Mom too did well in the C-section.

Later that night I went to check on this Sangape family and found both babies and mom doing well.  Despite the poor radio communication, mom and babies should do fine and be able to go home after the babies get stronger and bigger.  A little bit longer and the 1st one would have died, and had mom stayed out in the bush much longer she and the 2nd twin could have also died.  Praise God for helping to protect these babies.