Lohrs Letters: Another Day
by Jason Lohr
September 1, 2009
“Are you serious? I don’t believe it!” I said to the doctor-on-call. And I couldn’t believe it until I went to the Emergency Department and saw her with my own eyes. There she was, fully pregnant, in labor, shouting out with each contraction.
Two weeks earlier I had seen her in our clinic. She had come regularly to every prenatal visit, doing all her lab tests, getting her ultrasounds, taking her vitamins. But there was a problem. She had two children at home, both delivered by c-section. That meant she would need another c-section, which she didn’t want. In fact, she had refused. So we called her husband. He came and we explained the need for a repeat c-section since the risk of rupture to the uterus was too great to allow her to deliver vaginally. The husband had agreed to the surgery, although the wife still seemed hesitant. They promised to come back in one or two days.
Instead of one or two days, it had been two weeks, and here she was in our Emergency Department. For the past two weeks, she hadn’t come back to the prenatal clinic. When her labor had started, she went to a church, hoping to deliver her baby there. But her contractions weren’t strong enough and the baby wasn’t coming out. So she finally decided to come to the hospital. Needless to say, I was a bit angry. We had explained everything to her and her husband. They knew the risks.
After examining her, we discovered the baby’s heart beat was racing rapidly (a sign of distress) and the cervix wasn’t opening despite her strong contractions. Now we had two more reasons for her to need a c-section.
We rushed her to the operating room, wanting to get the baby out immediately. Anesthesia was given, she was prepped and draped, we prayed (which we do before every surgery) and then I made an incision over her lower abdomen. As I cut down into the abdomen and reached the uterus, I discovered something strange. Even before cutting into the uterus, I felt the baby’s head outside the uterus. Then I realized her uterus had ruptured! The baby was just clinging on for life. Normally in this situation, the fetus would be dead.
Without making any cut into the uterus, I used the ruptured portion and extended the rupture so that I could pull out the baby’s body. I quickly handed the small infant to the nurse and attempted to repair the well-torn uterus which was pouring blood in all directions into the abdomen. Eventually, after placing many sutures, we were able to stop the bleeding. I was amazed that in spite of this patient’s refusal to follow our advice and a ruptured uterus because of it, the mother and baby both survived.
Another day. Another miracle. Or in this case, two miracles. We thank God for the miracles we see every day in this place.
Jason
Two weeks earlier I had seen her in our clinic. She had come regularly to every prenatal visit, doing all her lab tests, getting her ultrasounds, taking her vitamins. But there was a problem. She had two children at home, both delivered by c-section. That meant she would need another c-section, which she didn’t want. In fact, she had refused. So we called her husband. He came and we explained the need for a repeat c-section since the risk of rupture to the uterus was too great to allow her to deliver vaginally. The husband had agreed to the surgery, although the wife still seemed hesitant. They promised to come back in one or two days.
Instead of one or two days, it had been two weeks, and here she was in our Emergency Department. For the past two weeks, she hadn’t come back to the prenatal clinic. When her labor had started, she went to a church, hoping to deliver her baby there. But her contractions weren’t strong enough and the baby wasn’t coming out. So she finally decided to come to the hospital. Needless to say, I was a bit angry. We had explained everything to her and her husband. They knew the risks.
After examining her, we discovered the baby’s heart beat was racing rapidly (a sign of distress) and the cervix wasn’t opening despite her strong contractions. Now we had two more reasons for her to need a c-section.
We rushed her to the operating room, wanting to get the baby out immediately. Anesthesia was given, she was prepped and draped, we prayed (which we do before every surgery) and then I made an incision over her lower abdomen. As I cut down into the abdomen and reached the uterus, I discovered something strange. Even before cutting into the uterus, I felt the baby’s head outside the uterus. Then I realized her uterus had ruptured! The baby was just clinging on for life. Normally in this situation, the fetus would be dead.
Without making any cut into the uterus, I used the ruptured portion and extended the rupture so that I could pull out the baby’s body. I quickly handed the small infant to the nurse and attempted to repair the well-torn uterus which was pouring blood in all directions into the abdomen. Eventually, after placing many sutures, we were able to stop the bleeding. I was amazed that in spite of this patient’s refusal to follow our advice and a ruptured uterus because of it, the mother and baby both survived.
Another day. Another miracle. Or in this case, two miracles. We thank God for the miracles we see every day in this place.
Jason