Diamondguaps

5/11/00 116th birth handled (302 births present)

I was on night shift when my patient Sherlita V., 32 y.o, G2P1, 40 5/7 weeks AOG, came in with her husband Luisito at 12:28 am, she was 3 cm, with no BOW, 60% effaced, sutures 1-7, -1 station. I monitored her every hour (FHT, TPR BP) since her Bag of water was already rupture she is prone to infection. After three hours of monitoring she wants to push and she was fully. I moved her to the birth stool.

At 4:47am the baby’s head was already visible but Carla can’t as what Krys M charted. At 4:56 the head was out. It took me 2 minutes to manuever to let the baby out because of tight shoulders. A very beautiful baby girl “Lushelle” was out at 4:58am with Apgar score of 6/9. We suctioned and stimulated the baby to cry and she was given free-flow oxygen. After frew minutes the baby was crying lusty. She weighed 3600 grms/7.15 lbs.

For the mean time, the patient started bleeding a lot while the placenta was still inside. I tried to do some cord traction but still it was very hard. So I did a manual removal of the placenta. It was really needed because we can’t do things to stop the bleeding if the placenta still inside. I was hard for me but it was harder for the patient. Her uterus is retroverted so I had almost my whole hand in her. It was so weird and very nasty. I had blood all over my hand. But I did not mind, all I was thinking is to get the placenta out and stop the bleeding. I had to do everything even in my own risk to save the life of the patient. Thanks God I got the whole placenta with extra lobe in it. We injected the patient an 10 “U” pit and massaged the fundus vigorously. She was on antibiotics for 7 days to prevent infection.
Patient had a laceration that needed to be sutured. It was sutured by Inneke E. And Sara J.
Present at birth : me, Carla S, Krys M and Kari M
1st stage – 4 hrs 30 mins
2nd stage – 28 mins
3rd stage – 09 mins
Admitted – 4 hrs 42 mins

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