Posts Tagged ‘bleeding’

Birth story #5

Sunday, November 15th, 2009

4/28/00 – 115th birth handled (294 present birth)

I was on night shift. Loudeliza, 33 y.o, G5P5, was endorsed to me from Ana. I did an IE at 7:02pm, she was only 2 cm. After the IE her contractions peaked up. There are many cases that a IE stimulates contractions that is why it is not advisable to do an IE with premature labor.

She was on her active labor. I advised her to deep breath and relax and lie on her left side because she had a borderline high BP 140/94. At 9:49pm, she was already 4-5 cm, 80% effaced, +1 station, with IBOW (intact bag of water.

At 10:020pm, she was 9cm and wanted to push I did an AROM which helped the baby’s head down, with moderate meconium stain. I held up the cervical lip while she started pushing. She was fully but the FHT (fetal heart tones) went down so we gave her an oxygen and the FHT peaked up. At 10:34pm a big baby boy “Lourd Artem” was born with Apgar score of 7/9, we suctioned and stimulated the baby to cry. He responded well. He weighed 850grms./8.8 lbs.

The placenta was out at 10:38pm. She only lost 200cc of blood. We gave the patient a 10 “u” pitocin as prophylaxis because considering she is multipara and had a big baby, she had a high risk for bleeding.
Present at birth: me, Grace E, JJ & Celeste C
1st stage – 18 hrs 30 mins
2nd stage – 15 mins
3rd stage – 04 mins
Admitted – 3 hrs 40 mins

Birth story#4

Friday, October 30th, 2009

My 114th birth handled (293rd birth present) 4/28/00

My patient Rosario O., 26 y.o, 40 3/7 weeks AOG, G1P0, came in with her husband Rodnie at 8:26 am, I did an IE she was only 1-2 cm, 70% effeaced, +1-+2 station. I advised her to walk around and a great time.

At 12:45pm, she wanted to have another IE so I did one. She was only 3 cm but very stretchy cervix, I tried to spread my fingers to somehow help it stretch more, she dilated to 6cm. I did manual dilation of the cervix. It is only possible if the cervix is very stretchy and making sure the cervix will not lacerate.
At 1:29pm, she was already 9cm, I let her to her left and right side lying alternately as it will help the cervix to open and at the same time it will help her not to focus on pushing before the perfect time to push.

She wanted to push. There was no progress. I did an AROM (artificial rupture of membranes) to help her progress with thick meconium stain which is not good. It signifies that the baby was already very distressed inside. Of course before doing it, I made sure that the presenting part was already +1 or more station to prevent cord prolapsed.

After knowing that there was a meconium stain, the suction machine was prepared to suction the baby’s nose and mouth when the head is out before the baby cries to prevent the baby from aspirating the meconium to his lungs. When the head was out we suctioned the baby and continued suctioning after the baby was out at 2:01pm. We got a lot of meconium visible in the suction tube and in the suction bottle. The baby was so cute. Her name is Nathalie Jhelan, with apgar score 9/10, weighed 2987 grm./6.9 lbs. Praise God everything went well.

The placenta was out at 2:04pm with a gush of blood. We massaged and injected 10”U” pitocin to stop the bleeding. She lost 450cc of blood. She had a 2nd degree laceration on perineum and labia and I sutured her. It felt so great to be a part of the birth. Present at birth: me, Carla Snyder, Ana Tipan
P.S. I also deliver’s second baby on 4/25/01.
1st stage – 14 hrs 56 mins
2nd stage – 5 mins
3rd stage – 3 mins
Admitted – 4 hrs 54 mins