Wednesday, October 26, 2011

The rush continues... Rupture uteruses and maternal deaths

Although we are quite busy with the Golden Jubilee celebrations, we continue to see patients who are quite sick. I'm glad that I've got Drs. Nandamani, Shishir and Johnson working fulltime and Dr. Angeline, my better half. This has been an unusual period of increased patient load which we have been having over the last couple of weeks.

Over the last 5 days, we had 2 rupture uteruses, one of whom died and another maternal death who had come with eclampsia. So, I did fill up the facility based maternal death forms and submit to the district nodal officer. Hope they were not shocked to see 2 reports come in after the meeting we had last week.

Last 2 days, we had more sad cases. There are 2 mothers with eclampsia for whom we did cesarian section and were blessed with live healthy babies. Unfortunately, we had a mother with pre-eclampsia on whom we did cesarian section and delivered a sick baby. The baby died soon after.

Today, there was one more near miss. The lady had been in labour since 2 days, before the family decided to take her to the district hospital. They kept her in the district hospital for about half a day before they decided to refer her.

On arrival in NJH, we found out that it was indeed a hand prolapse and a dead baby. We were not very sure how long she was in labour. We decided against doing an internal version as there was a bit of a doubt on the integrity of the uterus.

Ultimately, we did the Cesarian section to deliver a dead baby.

Almost all the patients  mentioned above who survived could have died if we had not done anything on them when they came to us.

The last sick patient in the ward is a little boy with a very bad fever. His counts have been rising after admission and I suspect him to be in a very bad septicemia. The father badly wants to take the boy to a higher centre, but has no money.

If he stays on - I shall do an LP on him tomorrow.

However, over the next 5 days, I pray that we would not have many sick patients as I'm afraid we would not be able to do full justice to them in the middle of a very busy week of celebrations of 50 years of the existance of NJH closely followed by the Eastern Regional Administrative Committee meeting.

And to top it all, there is a young man with tetanus who has uncharacteristically turned up quite early and has been doing well.

Pray for us . . .

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