OF THE "DOUBLE O"

So this day am in labour ward, the most dreaded twelve hours we each get....yaani by the time am done with each call I sleep for like twelve straight hours and still end up with aches and pains even in places you can't possibly imagine!!! But I love it, the screams, the curses, the adrenaline and best of all the smiles of mothers and cries of  new babies...totally fulfilling, I always head back home with high spirits in a battered body though!

A young university girl studying in Makerere caught my attention and we just started chatting, she told me the usual story of girl meets boy, girl gets pregnant, boy and girl don't want to get married so quick under the guise of the baby so they are waiting for the right time, come on people........come on, you will eventually get married so WHY NOT JUST DO IT ANYWAY BABY GUISE/ PRESSURE OR NOT???? Lol! Now to medical issues ahem! so during the ward round when we get to the bedside, the CTG (It is a machine that records the baby's heart rate in the mother's belly, and helps us monitor baby's condition during labour) appears abnormal. The baby's heart rate was dipping and rising in a very characteristic pattern. So the consultant asks what we think is happening and I quickly say that the baby seems to be having an element of distress. He takes this discussion a notch higher and asks in what condition do you see this an d I stare at him blankly.

For those who know the Double O know that that is a teaching opportunity and he grabs it. He says that that kind of pattern is seen when there's a loop of cord being compressed by the baby on the shoulder against the mother's pelvis or in cases where the cord is extremely short. Advice,assess the lady and watch the baby's condition and in the event that there's significant compromise I plan for an emergency C-section. I get back to our patient after seeing the rest of the patients. On doing a vaginal exam she is 4cm dilated, a quick ARM(artificial rapture of membranes which is done to expedite delivery) reveals meconium like Grade 6!!(OK, meaning baby has passed stool in the uterus and this is a sign of fetal distress i.e. fetal well being is threatened)

Our emergency theatre is occupied and in such an instance there is no room for waiting so matron manages to get us a theatre upstairs and I have to scrub in and save this baby...(Did I say I love the adrenaline rush???). Well, I get into the uterus and deliver the baby covered in greenish stool, but the most amazing thing is that as soon as the baby was out the placenta followed spontaneously, reason being?? The cord was so short....like 10cm long( a normal umbilical cord averages a length of 50cm!), If we had allowed the lady to continue with normal labour, or had we delayed the artificial rapture of membranes at that point, the baby would have descended into the pelvic canal and the short cord would have pulled the placenta along with it causing sudden detachment called placenta abrutio and the baby would have bled out and died! And you don't want to imagine what we would be dealing with to save the mother's life!

It was a victory for me, I almost high fived my consultant for his "wisdom" and definite experience which saved a life! At that point I had so much respect for the double O, I had a new insight into the saying experience is the best teacher! I hope my patient has now gotten married to her baby daddy.......(a story for another day!)

On a different note, today I delivered a footling breech(case where the babies legs are delivered first instead of the head), yeah one of those difficult cases where the cervix is not fully dilated so the head gets "stuck"....many manoeuvres and baby was out! little victories!

Night people!