30.03.2020 Case 106

Baby Diana 

Woke up this morning feeling awful as I had spent the night emptying my gastrointestinal system (rather common here and well its not Corona but actually these bothers are more common anyway).  The midwives informed me of a bad CTG with decelerations and the need for a C-section.  The patient had already one before so I was a bit nervous.  The scar on the skin already suggested the previous procedure had been done in a haste as it was pretty big and not quite at the right level.  The inside was a mess, muscle layers mixed into fascia.  Slowly made my way down to the uterus that looked very scarred and had an irregular surface.  The cut into the uterus went okay but the structure on the distal end of the cut was very hard.  During delivery of the head this structure ruptured and caused a V-like rip in the center towards the bladder which luckily didn’t get injured.  Carefully suturing this area I noticed there was very little muscular structure to adapt.  At the end it was all put back together and free of bleeding, relief.  My stomach was still aching from the GI troubles the night before though.  Must speak to this patient about further family planning, this is not an operation I wish for anyone to have to repeat!  Case #15 and 106 overall.