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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