Wednesday, July 3, 2013

Cord prolapse

I figured I would probably have to deal with some crazy stuff while here, it seems everyone else that has ever told me stories about Vanuatu talk about the one ever lasting memory of the crazy scary emergency that happened. Mine got to be cord prolapse, well at least I hope that is the scariest it gets while here… I might like and easy breech or twin though… but no more emergencies please!


I caught 3 babies today, the 3rd right before Elias and I were going to leave. I wanted to leave early because yesterday we were at the hospital for 14hours, running around doing a million things. It was this momma’s 4th baby and I figured it would be quick and easy then we’d go home.


Let me give you a little background, yesterday there was a mom who had a cord prolapse and the baby died, same thing like a week or twon prior (as told to me by someone working at the hospital, we weren’t here yet). I think most people reading this know that cord prolapse is a very rare emergency (it seems to happen here a lot more often) where the baby's cord falls out through the vagina (or just past the head) gets compressed between the baby's head and moms bones and most often baby dies because they don’t do a c-section quick enough.


Well, she started feeling an urge to push, I checked her and she was fully dilated, the head was low but not coming lower because of what felt like a huge bag of water over the baby’s head. I figured she’d give one good push and that bag would break and flood everywhere, or be really thick and inhibit descent. So I routinely checked for the cord over the baby’s head, as we are taught to do. Elias put the Doppler on baby, all very routine... during a contraction I barely touched the bag with the amniohook and it broke it, I controlled the descent of the head a little (didn’t have far to go at all, but with a G4 I figured she’d have so little resistance to baby coming quick). Baby's heart rate started tanking, I checked and felt a cord along the top/side of the head (with all of that fluid it flushed it down further toward the opening), we flipped mom to knee chest position and called the dr for emergency c-section, but supposedly an ER CS takes like 30-40 minutes here (supposedly that is what happened last week) and the baby would already be dead (or we would have to hold the baby’s head up until the surgery was ready and would be quick), so I shoved my entire hand up momma (as she quite audibly complained  because it f***ing hurts to have somebody's hand inside you next to your already huge baby head), pushed the cord back inside as far as possible, kept trying because it kept slipping and baby's heart was low, I was really persistently trying to get it to go around baby's neck and stay, and eventually it did! Heart rate went up and we had momma push like a crazy woman... the cord was still tangled and had some dips and since baby had been deprived of oxygen for so long we didn’t know how baby would handle everything, .... I was so, so scared that the baby would die... but ~30 minutes after the cord had first prolapsed the baby was born and cried pretty quickly (30 minutes is way too long to not know if this little baby is going to live), after the birth everyone was still and quiet. I am so thankful he lived. He complained a little while and then started smiling... No kidding, he started smiling, and babies don't commonly smile when they are awake and newborn… they smile in their sleep or when they are older... but he seriously was smiling, several times. He laid there on mom and the cord pulsed for so long, I really think it was quite beautiful that it pulsed so long to give him all the oxygen he needed that he was deprived of :)

What a day! I am tearful now just thinking about the poor momma that had lost her baby yesterday and how this sweet smiling little boy might not be alive right now...


No comments: