Tuesday, January 15, 2013

Whoa . . . what a rupture?

I returned yesterday evening from the short break, thanks to the twin days of general strike. It was a risk taken . . . calculated risk . . . but really risky to drive back on the afternoon of the second day of the bandh. The good Lord was with us. However, we wanted to back badly . . . for multiple reasons.

Today morning, we had a mournful looking man in my office. Husband of Sde, a lady who had a rupture uterus in her first pregnancy. Something very unusual, but quite possible in our part of the world.

The poor lady had been in labour for almost a whole day, before the relatives decided to take her to the hospital. The first hospital they went to could sense that something was drastically wrong . . . and referred the patient promptly to Ranchi.

They dropped at NJH and wanted us to take up the case.

Dr. Shishir was on call . . . and the diagnosis was unbelievable. It was an obvious rupture uterus and of course, the baby was dead. She was lucky to be alive.

Per-operatively, the condition of the uterus was very bad. Dr. Shishir had to nick off quite a lot of necrotic tissue before he could sew the uterus back. Being a primi, he did not go for a tubectomy.

A tubectomy would ensure that the lady is abandoned by her husband. It’s been a long time since we’ve had a primi rupture uterus. Believe me, it’s really bad.

Sde had developed fever with breathlessness overnight. Either she was going into septicemia or she had atelectasis. Investigations showed the former. We’ve upscaled her antibiotics.

We hope that she would not have any more complications. Ultrasound also shows that the uterus appears intact.

In addition to SDe, we’ve had another 4 patients at some stage of eclampsia. Interestingly, we’ve got all the babies alive . . . something very miraculous.

Before I sign off from this post, just a reminder about the staff needs of the place . . .

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