Archive for the ‘Uncategorized’ Category

Birth story #3

Tuesday, October 27th, 2009

M113th birth handled 4/25/00

My patient Helen T. 29 y.o, 39 weeks AOG, G5P4, came in the clinic with her husband Jose at around 10:25 pm. I checked her in and did an IE, she was only 2cm, 60% effaced, no bag of water felt. The fetal heart tones heard most loudly in the LUQ (left upper quadrant). I was so sure thought that when I did an IE I felt the baby’s head. The patient was so very sweet. She was always smiling at me even she has contractions.

At 2:00am she wanted to have another IE, so I did one and was 4cm, 80% effaced. She was doing fundal pressure every contractions with herself even I told her not to as it can hurt the baby. After a while she felt her legs shaking and I though she was already fully but to my dismay she was only 6cm.

So I take a nap on the couch for a while then after 12 minutes Ate Toinnette shouted my name and I wake up suddenly as if my heart was displaced out of my body. I jumped off from the couch my pens, keys, and thermometers in my pocket were all scattered on the floor. It was good that Grace came to the patient’s cubicle first and saw that the head was already coming so she supported it with her bare hand. When I arrived the baby’s head was already out so I suddenly put on my gloves. There was a single loose nuchal cord so I slipped in on the baby’s shoulder. Then the baby was out very fast at 3:02 am, a very cute baby boy named Jessie, with apgar score 9/9, weighed 2700 grms/6 lbs.

The placenta was out at 3:08am, with only 50cc estimated blood loss. No laceration. Everything was normal no problems. Praise God. After they were settled, I felt tired because you know what happen after the adrenaline rush. I tried not to think that I was kind of a negligent nurse/midwife but it was good that we had a good team.
Present at birth : me, Tionnette R, Grace E.
1st stage – 5 hrs
2nd stage – 2 mins
3rd stage – 6 mins
Admitted – 3 hrs 08 mins

Bith story #1

Tuesday, October 20th, 2009

My 112th birth handled 4/30/00

I was on Day shift. I was the first up supposed to be I will receive the patient Noralie came to our clinic on at 4:45 am, 25 y.o, G1P0, 6cm. She was Carla S’s patient to stay so we handled this patient together. The patient extreme reacting to labor pains but was able to control it and deep breathed.

At around 8:15 am, she had the urge to push so I did and IE and she was 8cm, with very stretchy cervix 90% effaced, +1 station, membranes felt so we let her breath.
After few minutes, she really wanted to push. When I checked her she’s 9+cm, so lifted up the cervical lip 5-11, then she pushed hard while I was lifting the lip above the baby’s head. She really did great pushing. After 2 minutes, she was already fully. I let CS take over, then baby’s head was visible, the after another push the head was out with single nuchal cord (umbilical wrapped on baby’s neck) loose, so it was slid on the baby’s shoulders.

During the delivery of the baby’s head the patient was bleeding) from the laceration. Then finally the baby was out at 8:43am, a healthy baby boy “Michael Dave”, apgar score 9/9, weighed 3100 grms/ 6.13 lbs.

After the birth the patient was bleeding a lot. CS put pressure on the laceration with sterile gauze, but still she continued bleeding and her cervical prolapsed. So I supported the cervix while doing CS was doing cord traction to let the placenta be out but still the placenta still attached.

The patient was on the birth stool, so I let the patient lie on bed. Then the placenta was out at 8:48am, the cervix was still visible, so CS massaged the fundus upwardly. I gave the patient a 10 “U” pitocin to help the uterus contract and stop the bleeding. When I examine the placenta, I thought there was one cotyledon missing but thanks God there was none. The patient has a big fat second degree laceration that I sutured. She lost 650 cc estimated blood loss. What a birth to start with my day. It was hard but thankful that everything went well with the patient and the baby.

Present at birth: me, Carla S, Lynn J, Julie T
1st stage – 4 hrs 32 mins
2nd stage – 11 mins
3rd stage – 5 mins
Admitted – 3 hrs 58

Breech delivery

Sunday, September 6th, 2009

Our shift was very busy. We had 4 patients in labor. Ater the 2 patients delivered their babies, there was another patient who came in labor that wanted to push right away. It Miss P who is up so I let her know that she has a patient. I helped her set up the birth but when the patient started to push, she saw a hand coming out. When I look at it, it wa not a hand, it was a foot and a butt. She immediately said that we will not be able to handle this birth, so I took over. The patient was pushing and when the body was out, it was hard for me to reach for the hands. But thanks God for giving me wisdom and strength to get the baby out. We were ready for Neonatal resuscitation but the baby only needs a little stimulation and oxygen. Then the baby cried and was breastfeeding good. To God be the glory. It was scary but everything went well. The baby only weighed 2,400 grams. It was one of the shift that we do not expect complicated things.

Perineal repair

Sunday, July 26th, 2009

I worked swing shift today. I worked with runny nose and teary eyes because of allergies. I ate chicken. We had two births. One of our patients bled a lot. She lost 1200cc of blood because of bleeders from the perineal laceration. It was hard to find the bleeders. I managed to clamp it with haemostat. I found 3 bleeders so I put 3 hemostat in their. I sutured the patient right away. Actually, I was not the one who supervised the birth but the other supervisor asked to do it. We gave Intravenous fluids. Before the patient delivered we already noticed that she had a previous laceration that was not sutured. Some of the parts are not already aligned and there were already growth tissues. In other words, it looked like she already had 10 babies instead of two.I offered a free vaginal repair if she wants to. It is so expensive when you have it. I haven’t do vaginal repair yet but I saw and observed the doctor did it 3 times. The patient agreed. But God’s grace, I was able to repair her vaginal great. I felt so happy that it was successful. The patient, mother and the husband of the patient were so glad. After I am done with the repair another labor came just right before endorsement.6/11/09

Merry Christmas everyone!!

Thursday, December 25th, 2008

img_0837 Merry Christmas everyone!! I hope everyone is having a wonderful time their family and friends. We have a marvelous time with our family because all of the members of the family are present. Christmas is a great way to ponder that Jesus our savior was born which the the reason for the season.

Christmas is celebrated throughout the Christian population, but is also celebrated by many non-Christians as a secular, cultural festival. Because gift-giving and several other aspects of the holiday involve heightened economic activity among both Christians and non-Christians, Christmas has become a major event for many retailers.

The children in this photo are the son and daughter of my cousin that I delivered at home. I cant imagine how they grow up so fast. Aren’t they cute?

Uterine Myoma info

Monday, December 22nd, 2008

When we knew that our patient did not carry twins, instead had uterine myoma, I did some research about it. Actually, that patient did not come back for her prenatal check-ups. If she did, that abnormalities was detected through ultrasound. These are some info of Uterine Myoma.

Uterine myomas also called “fibroids” are tumors that grow from the wall of the uterus. The wall of the uterus is made of muscle tissue, so a fibroid is a tumor made of muscle tissue. The fibroids start off very small, actually from one cell, and generally grow slowly over years before they cause any problems. Most fibroids are benign; malignant fibroids are rare. The cause of fibroids is unknown, although it is known that fibroids have a tendency to run in families.

The most common symptoms are:
• Cramping with periods.
• Heavy flow or clots with periods.
• Discomfort, such as pressure, as well as being unable to lie on your stomach and being unable to button your clothing easily, caused by the mass of the fibroids. Other, less common symptoms include irregular bleeding and urinary frequency caused by the pressure on the bladder from the fibroids. If your periods are very heavy, you may become anemic and an iron supplement may be recommended.

If fibroids become symptomatic enough, they can be removed surgically. The most common surgical approach is to perform an “abdominal myomectomy. An incision is made in the lower abdomen into the abdominal cavity, and the fibroids are removed from the uterus and the uterus stitched closed. If the uterus is no longer necessary (the woman is finished having her family) and the woman desires her uterus removed, a hysterectomy (removal of the uterus) can be performed. (A “hysterectomy” is removal of the uterus and cervix, not removal of the ovaries.