Background:
Life is a struggle but here a Dead struggled to born…
This is the case difficult vaginal delivery when there was no ultrasound facilities present around our place…
Sunday, April 11, 2010
Case History
Case History in Brief…
1.32 years unregistered fourth gravida patient came in labor pains.
2.She was examine in labor room.
3.On examination general exam was within the normal limits..
4.Per abdominal full term Pregnancy…vertex presentation…but Fetal Heart Sound were absent…reconfirmed by Doppler.
5.There was vertex presentation and head was at nearly crowning stage.
Line of management…
Line of management…
1.blood send for basic investigations and IV line was setup.
2.Informed relatives regarding ‘Intra Uterine Fetal Death’...
3.Staff was ready with for vaginal delivery.
Difficult Delivery…
It was difficult delivery…
1.Episiotomy after injecting local anesthesia was given…
2.Head of the stillborn came out easily…
3.There was no further descent...
4.Piticine drip now started slowly…
5.Stillborn’s posterior hand was delivered by hooking shoulder by putting index inside…
6.Then another hand delivered with help of assistant doctor’s supra pubic pressure..
7.Both the shoulders were out…but no further descent…
There was no choice…
And we had No Options and No choice…
1.By palpation through inserted index and middle finger…opinion was difficult delivery is due to enlarged fetal abdomen…fetal ascitis…
2.Fetus was pulled slowly…now…there was no other option…
3.Artery was inserted guided by index of anther hand deep into abdominal cavity of fetus…site chosen was just below Xiphi sternum…
4.Some of the peritoneal fluid came out and baby delivered by controlled fundal pressure…
5.Rest management was as usual…
Dead made his entry
Dead made his entry
Finally Dead was born…
…and made his entry…
…. in the Deadly Living world.
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