I encountered a
emergency labour case few weeks ago. The patient was a G6P5 , 39 weeker. The
husband had rushed her into our ED during a busy Saturday. We had double
consultation going on but yet, the initial scenario stunned my nerve. My
colleague (a junior cardiovascular surgeon) told me that she had no experience
of handling such case. The 2nd event was the meconium stained liquor
which was noted on my vaginal examination. The os was fully opened and
contraction was regular. Rupture of membrane was noted few hours before their
arrival. No pitocin/ergot available was another disturbing fact which should
have been corrected a long time ago. While I was worried about how could I take
care of both the patients, one of nurse told me that our visiting obstetrician might
still be around. She had called up and the obstetrician came to ED and took
over the labour. I set up another resus area praying that the kid would be fine
after delivery although the quick sonography look revealed the kid’s heart was
still pumping.
The baby came up
within minutes and I was cheering when the baby was passed over to me….the
Apgar score was 9 and I did a suction via endotracheal tube without difficulty….
1 hour later, the
mother and baby were on their way to another hospital.
I was lucky the
baby did not come out flat, although there were still a few things to complaint
about. The visiting obstetrician did not repair the episiotomy wound and he
later refuse to issue the birth certificate. I had asked around and found that
he had some medico-legal issue earlier and he had given up his practice of
obstetric. He is currently attached to our health screening team and doing pap
smear only. I had recalled once that I had consulted him about a missed
abortion for DnC and he told me that he is a Buddhist and declined the job.
The medico-legal
case had scared the hell of out of him; lots of the obstetrician had quit and
practice cosmetic medication since the last 10 years.
Well, I am not the
lucky one that day….the kiddo was….
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