02.02.2020 C-section #5, Sunday #3 in a row

02.02.2020 - Todays date is a palindrome!  It also marks the third Sunday in a row that necessitated a C-section.  This time the patient came in the afternoon and was presenting with a pathologic CTG and a stagnation in the birthing process.  The contractions just weren’t very effective.  We tried to provoke stronger and longer contractions using oxytocin but the baby started to react to this.  So without further time loss, as has been the case in the past where a transfer was necessary to a clinic far away (gynecologists but limited resources) we were able to go straight into the operating theater.  There was a little trouble with external bleeding at a few sites on the anterior and posterior wall of the uterus.  A few sutures sufficed for the bleeding to cease thankfully.  Overall we had a slightly lax uterus so we kept it toned with an oxytocin drip post-partum.  

Regarding the baby, it was evident however from delivery that there was no amniotic fluid.  Upon further investigation I found out that the women post delivery date are only monitored for weight, blood pressure and urin status.  No CTG or measuring of the amniotic fluid index (AFI) using sonogram at regular intervals takes place.  After this case we have now implemented using this standard technique.  I will begin teaching the local doctors and senior midwives how to measure this using the ultrasound machine. 

C-Section #5 Baby girl Fanantenana