two mothers - april
Last night, a mother delivered a pre-term baby. He was only 6 months in her womb. He was mostly developed, except that the eye slits still could not be opened. He was limp and blue. And he only had 2 hours of life before he passed on.
The mother knew this before she even delivered, but had to go through with it with the hope that she could save that tiny child. It took (a lot) of courage and she was blessed with that life, even if it were only for 2 short hours.
I, thus, re-learned something today: that at 23-24 weeks AOG (about 6 months), the eyelids could not open yet.
Oh yeah, and that a person’s a person no matter how small.
naala ko tuloy ung nadeliver ako ng super preterm fetus sa isang hospital sa marikina back in 2006…
ung mother is a kasambahay, galing na cya sa isang private MD a day before, with the same complaint - hypogastric pain that radiates to the back with dysuria. And she was treated by that particular MD as a case of UTI (maybe because like when i took her history, she denied missing her menses, in fact she claimed her LMP was 2 to 3 weeks prior). she was given an antibiotic and HNBB (Buscopan) tablet.
back to what happened…
like her previous MD, i planned to treat her as either a case of UTI or ureterolithiasis (stone in the passageway of urine). after or sending urine specimen for routine urinalysis only, because she refused pregnancy test to be done (she did signed a waiver in her chart), she excused herself and went to the CR. a couple of minutes later, we heard a scream from the CR. when her employer and i checked, there was something dangling from her privates… we brought the girl immediately to the ER bed.
to make the story short, i delivered a very tiny fetus, about half the size of my hand. the fetus was still breathing for almost an hour. i had to intubate the fetus when his breathing slowed to less than 20, and the attending pediatrician was still 30 minutes away from the hospital.
i have to admit, that case was a couple of first for me (intubate a fetus and inserted an umbilical catheter)…
that fetus was a fighter… he hold on to his dear life for almost 3 hours…
moral of the story for me? never give HNBB (Buscopan) to a child-bearing woman without pregnancy test, even if they signed a waiver in their chart that they refused to have the preg test done.
and also an “oh yeah” moment… like what you said doc zoe: “a person is a person no matter how small he is”
idelMD said this on November 11, 2008 at 6:35 am
oh no.
those suspiciously preggy women are just some of those types of patients i fear. it has just reaffirmed that when suspicious, it’s better to be safe, or threaten the woman into telling the truth - haha!(”kasi kung buntis ka at binigay ko itong gamot na ito, baka maging delikado ang kondisyon mo at ang buhay ng baby mo.” pag di pa sya natakot, ewan ko na lang.)
thanks, idel!
kabibe said this on November 11, 2008 at 12:10 pm
ang masama nun, she claimed na nag mense cya 2-3 weeks prior. at with conviction nya sinabi yun. at di cya mukhang buntis or iisiping buntis, kc 15 or 16 lang ung bata.
actually nung dumating cya dun sa ER, mukhang nagstart na cya maglabor, kc parang nabigyan na cya ng buscopan IV/IM dun sa pinanggalingan nyang clinic at malamang nakainom na cya ng at least 1-2 tablets kc around 6pm na yun nung nakita ko cya.
pero, malamang may factor din kaya nagsinungaling cya dun sa unang doctor at pati na rin sa akin, dahil kasama nung babae ang amo nya. baka natatakot.
naawa lang ako dun sa baby. wala cya kalaban laban.
ang naging pakunswelo ko na lang sa sarili ko nun, malinis ang kunsensya ko sa nangyari dahil hindi ako ang nagbigay/nagreseta ng buscopan sa kanya, at buti na lang din na di ko pa naoorder sa chart na bigyan cya ng buscopan. pero na-bother ako nun ng ilang araw, kc kung di lumabas ang fetus, baka nabigyan ko rin cya ng buscopan, trusting the info na sinabi ng pasyente.
idelMD said this on November 14, 2008 at 8:07 am
hay naku. bad girl! yun lang ang masasabi ko.
pero kawawa din sya. i can only imagine yung psych aspect ng dinaanan nya…
kabibe said this on November 23, 2008 at 6:27 am