Posted by Dr. Aditya Sharma, MD
A young women, pregnant for the first time, came to the clinic at around seven in the morning with painful contractions and bleeding. Dr. Jhapat and I, called in from the staff quarters, found a grade 2 anterior placenta previa (where the placenta obstructs the birth canal). We performed an ultrasound to see a good fetal heart rate, a full term fetus based on fetal measurements, and a vertex presentation appropriate for labor.
Seeing the gravity of the situation, we began to make arrangements for transfer to a hospital about seven hours away that presently had an obstetrician in residence. We also began preparing magnesium sulfate,
drug that stops labor, to help to buy time ahead of the long journey. Prior to administering the
drug, however, the baby started to crown.
Fortunately, the placenta was displaced upwards instead of outwards, and the placenta did not rupture (rupture can cause life-threatening bleeding). Dr. Thapa delivered the baby boy quickly, but the
infant was cyanotic (blue), inactive, and not breathing. Shortly after some manual suction and provision
of oxygen from the oxygen concentrator, the baby perked up and began crying.
The mother herself did excellent; the placenta delivered easily and subsequent bleeding is minimal. Both mother and her newborn baby were discharged from the clinic in the evening. We narrowly averted post-partum hemorrhage. This was yet another instance that demonstrates the importance of quickly building our obstetric surgical program at the new hospital.
Dr. Jhapat performing antenatal ultrasound