Zhifa
A passionate young soon-to-be medical doctor with interest in writing and #HealthForAll

Ob/Gyn rotation: when reality hits

During yesterday's rainy evening, a couple arrived at the emergency department of the hospital I'm working in. The wife was seen pregnant, the belly bump was obvious and they were bringing the pink book (all pregnant women who checked themselves to the clinics, midwives, doctors, were given this book to observe and evaluate their pregnancy); she was 40+1 weeks pregnant with her second child. 


I made my way to the maternal room to check on the patient, as the resident was still in the ward and she instructed me to look at the patient first. I took some history, the mother was hypertensive during the pregnancy but did not consume any medicine to help control the BP, 10 days prior to admission she was shivering but the husband noted no fever during those days, the last BP in the midwife clinic was 170/100 with protein urine +1, checked the vitals (her blood pressure was within normal range, but was already given meds before transported to out ER) and performed physical examination, identified the fetus's presentation, measured the fetus's heart rate and gave some education to the couple about the possible plan for the mother and the baby. 

As it was almost the end of my shift, I made my report and send it to the resident and she came to the ER to perform USG on the patient, the baby's heart rate and movement were okay, the placenta insertion was not obstructing the OUI. The feasible plan was to move her to the delivery room and hoped for her to have a safe delivery.

I explained the patient's history to my colleague who was going to continued the night shift. The mother was transported to the delivery room and was given oxytocin stimulation as her cervical dilation was already 4-5cm. I went home, and recharge myself for the next morning. As I was getting ready to go back to the hospital, I thought to myself the lady must've had delivered her baby by now and was expecting the two to moved to the maternal ward (I was in charge of that ward for morning rounds 06:00-14:00), but to my surprise, they weren't there yet.

I went to the delivery room to say hi to everyone and to check up on the patient, but my colleague explained to me that the baby's heart rate was not found during her 03:00 AM check up, they did USG on the mother and found out there was no cardiac activity and no fetal movement. The diagnosis changed from mother with pre-eclampsia with severe features 40+1 weeks pregnant intrapartum active phase to mother with pre-eclampsia with severe features 40+1 weeks pregnant intrapartum active phase, IUFD. 

The resident broke the bad news to the family and even though at first the husband was shocked and was in denial, he accepted the reality that the baby born will be a stillbirth. As for the mother, they broke the news via USG examination to made her understand clearly the situation involving the baby.

As to why this happened, I have questions, of course, but who am I to question His plan? I can only pray that it is Allah's plan and it is for the best. Imagining the pain the couple must be feeling right now must be too much, but Allah said in the Quran that no one will be tested more than what they can bear... I'm guessing the couple must be among the strong ones. And verily, with every hardship there is ease, inshaAllah. Hopefully they stay strong, have faith, and keep trying!

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