Saturday, November 24, 2012

Another maternal death . . .

Today early morning, Dr Shishir had a very interesting patient brought into casualty. RD, who was married for just about a year was brought in with severe breathlessness. She was pregnant and was nearing term.

The pulse could not be felt. The heart beat was quite muffled. The baby was dead. Obviously dead for quite a long time. There was edema of the fetus which had obviously increased the abdominal volume thereby compromising her lungs.

RD has been sick for quite a long time . . . since 3 months. The family did not bother to take her to any hospital. It was only when she became quite sick that they took her. The doctor had told her that it looks like tuberculosis.

From her history it looked like miliary tuberculosis. And she was all emaciated . . . only skin and bones . . .

I reviewed her ultrasound. There was fluid all around the heart . . .  a pericardial effusion.

She had already gone into labour. I did not know what to do. 

Then she had a cardiac arrest. No CPCR worked. 

I had hoped that we would be able to deliver her somehow.

But, we had lost the battle long back. It was sad to see another maternal death.

It’s been quite a long time since we've seen a maternal death caused due to most probably tuberculosis. There was no direct obstetric cause, save for the dead baby.

Another stark reminder on how dangerous tuberculosis continues to be in places such as ours . . . 

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