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my 1st night in maternity ward
hmm... o&g department kat sini is known as dept yg penuh dgn seniority & suke bully students/juniors. 1st year residents wajib belikan mknn utk seniors. kalau seniors buat salah, lampiasnye kat juniors. kalau on-call, memang xleh duduk! my partner and i was so nervous! tambahan pulak this week students yg on duty cume 2 of us. 6 other students (from the regular med class) tgh cuti. abis la... tak tau nak buat ape.
4pm- started our night shift duty at o&g emergency dept with ward round & briefing. kat maternity care unit ada 4 patients. in labour room (for patients in active phase, 1st stage of labour), 3 patients waiting 3 patients waiting for labour. 2 primigravidas and 1 2nd. isolation room, 1 patient with hepatitis, 1 with 4th stage cervical ca, another with ovarian ca - post-op. after introducing ourselves to the chief in charge, we were asked to separate - 1 (me) at the acute room, receiving new patients ; 1 for standby at labour room and other rooms.
alhamdulillah.... all 8 residens in charged were EXTEREMELY nice. lgsg tak seperti yg diorg cite.
acute room kosong. belum ada patient baru. so, mintak izin ke resident yg in charge kat situ utk ke labour room. kat sana, 1 mother had full opening after 12 hours in pain... just waiting for the fetus's head to be fully engaged outside the pelvic outlet. adequate contraction. 4 contraction per 10 minutes. fetal heart rate 132 bpm. i asked to help the midwife.
gloves on. bab's head seen. 1, 2, 3... push!!! only part of the head is out
1,2,3.. again push!!! still stuck...
again and again. mother is shouting in pain. might need episiotomy - mediolateral cut.
1,2,3.. push! alhmdlh... heads out. external rotation. posterior shoulder out. the other one out. now the baby is out.
i cant believe it! i cant believe it!
a beautiful 3360 gram baby girl is o my hands, crying pamperly. "alhamdulillah" cried the 26 year old mother.
congratulations...
who do i give my love to
my respect and my honour to
who do i give my love to
after Allah, and Rasulullah
comes ur mother
who next.. ur mother
who next .. ur mother
and then ur father.............
(thank u mama... - although i am born through c-section)
new patients came....
rushing to acute room, a 27 year old mother is examined by the doctor in charged. 29 weeks pregnant, twins. preterm cervical opening (3cm) and amniotic fluid rupture.
"the doctor at the hospital where i get my ANC says one of my baby is dead 5 weeks ago."
1 IUFD & 1 healthy. preterm rupture. hmm... USG shows 1 fetus is engaged to the pelvic inlet, but skull in pieces! what should we do!
the resident were all confused. i was invited to join the meeting. hmm... what an honour! no decision.
phone picked up, dialled consultant's hp no.
tocolytic drug given... to stop the contraction. + adequate antibiotic... prevent DIC caused by intrauterine infection caused by necrotic placenta & dead fetus. maybe adequate until 2-3 weeks, proceed with preterm vaginal delivery
OR
deliver the dead fetus first, without extracting the placenta. lower risk of DIC but putting the living fetus at risk.
hmm... interesting.
patients from 4pm to 6 am
- 4 spontaneous delivery (3 normal, 1 induced)
- 1 c-section
- 9 new cases
- 1 gamelli with IUFD
- 1 pre-eclampsia
- 1 post-abortion (induced, illegal) - infection
- 2 aterm pergnancy
- 2 post term pregnancy (1 unadequate amnion, 1 fetal bradychardia)
- 1 severe dysmenorrhea, suspected endometriosis
- 1 appenciditis (check up to confirm excluding other gynae diseases)
alhamdulillah, although only 1/2hr sleep, this was my best night shift duty ever had! superb team of resident, superb combination of cases.
looking forward for the next!
hmm... nape manusia perlu merasa lebih tinggi dari manusia lain? sedangkan sama2 dibuat dari substance yg kotor. sama2 hidup dlm rahim where fetus minum air ketuban, kencing, and minum air itu kembali. sama2 keluar dari lubang yg sama dgn bersama darah2 dan tak berpakaian. miskin, kaya, berpangkat atau tak, sume lahir camtu jugak. tak labour room tak dibezakan. kat neonatal room pun sume same. yg membezakan hanya either baby tu diazankan atau tidak.....
wallahu a'lam.
posted
by
husnulkhatimah
7/31/2005 01:55:00 pm
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