24.02.2020 Emergency

Emergency C-section.  One of those things I would rather do without.  The patient came in the morning with regular contractions and proceeded with good cervical dilation.  All seemed fine but by early afternoon the CTG started showing signs of stress.  We observed this for a while but it went from category suspicious into pathologic.  At 8/9 cm this would have been the time for a microblood analysis, taking a tiny drop of blood from the baby’s head to see if it has reserve for vaginal delivery.  Knowing this possibility of blood analysis does not exist here there wasn’t much time to wait.  An oxytocin drip was started to help support contractions.  This vaginal exam was promising showing good progress but the CTG got worse and the indication for an emergency c-section fell as the fetal heart rate dropped to the 60s and did not make any attempt to return to the normal above 110 bpm even after oxytocin had been immediately switched off.  Partusisten (as previously mentioned is not always available) was not to our disposal at this time.  We rushed into our adjacent operating room, and took up the ortho spot while hernia repair was taking place on the neighboring table.  (The team of German doctors is here for the week performing free procedures).  The c-section went smoothly and the baby was relatively fit, hardly what we expected but entirely relieved.  Here are some photos I took of the CTG after all this was over in order to sort out how this miracle came about!

Those of you working in labor and delivery probably know how I felt about these less than desirable CTGs, the second one is the reason for the emergency c-section.

#6 Notsectio Baby Fitia (somehow this names seems fitting to the situation)

Spontaneous delivery #5 for this patient who delivered just after we finished operating.  

Our hospital beds were now all full.  After a hard days work it was this sunset behind our hospital that rounded off an arduous day.  So thankful all our patients are doing well!