And finally, although we had quite a busy day on my first duty of 2012, we were lucky not to have a rupture uterus.
But, then we had the first rupture uterus of 2012 on my next duty day (9th Jan, 2012).
The duty was not much busy – save for the night, when I had 3 patients with previous Cesarian sections landing up with in a time period of 1 hour. The first two were without much problems.
But, the third one, BD had tried to deliver at home and ended up with a rupture. It was her 4th pregnancy. The first one was a normal delivery. The second one was the previous cesarian – but she had lost that baby during the surgery. The third one was a normal delivery – which may have prompted her to try to have her fourth one at home.
BD was visiting her parents when the labour pains started – most probably a reason for not trying to access health care. However, by the time she knew that something was amiss, she had called her husband, who was elsewhere. The husband was knowledgable enough to realize that she had ruptured and advised her to go straight to NJH.
So, she came straight to us. She was in shock – which she responded well to fluids. And the family arranged for couple of pints of blood.
Shishir did the surgery. By God’s grace, the rupture was clean and we were able to close the rent without much problems. She is making a good recovery.
But the family is quite upset that they lost a baby boy. The second delivery which involved a Cesarian section had also ultimately ended up with a dead baby boy.
Lesson learnt: The importance of finding out the decision maker in the family where a lady is expecting a baby soon and educating the decision maker about institutional delivery.