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
Tags: 2nd degree laceration, apgar score, aspiration, birth, bleeding, labia, lungs, meconium, perineum, pitocin, suction, suction tube