Mar 23, 2009

foot prolapse: that eerie waving hands

grateful to: both my HOD and Dr. M for letting me join NRP (neonatal resuscitation program), even if it is after my clinic. I'd been conducting delivery, attended to problematic babies first hand (and even intubated 1 baby) for almost 2 yrs without knowing the right procedure/protocol/technique. Luckily, nothing bad happen (touchwood).


2 nights ago, I was on call with Tim.

My call with Tim had always been sensational. super jonahism.

I had my first C-Section of the day early 8am.

Then, it was cool and I made myself busy working on my little study, hopefully to submit to OGSM on time.

There was 4 ERPOCs, completed late at night due to the non-urgent nature of the op. Leaving OT 0130H, I kept my fingers crossed tightly, hoping for a good doze off soon.

PC. Shutdown.

Clean up.

Lights off.

Entering NREM sleep cycle....

and minutes after entering REM sleep cycle, the phone rang.

- Oh. Shit... -

"Hi, Got 1 Caesar. 35 weekers Twin breech breech with foot prolapse. Foot out a lot."

Heart pounding faster.

"Ok, i'll be in OT soon. You come in, too. 2 heads better than 1."


"Any word of wisdom from Dr. M (specialist)"

"She just said for caesar"

- That's lots of confidence in me, probably she's on the way -

Patient on the table, inducing spinal anaesthesia.

I reviewed her red book. She was having uncontrolled BP, supposed to come 2 days before. She didn't turn up. She was leaking since the night before, but choose to come that night.

There goes the accountability of a pregnant mother to herself and her babies, or is it lack of communication from the prior doctor.

This is not her first pregnancy. My best bet is on the former.

Crash C-Section commenced, fearing further descend of the presenting part.

As I cut opened the uterus. There it was.

Facing me. The baby face and hands. The hands waving at me.

Eerie hands - means buttock may have been deep down.

(Palpitation) (Severe palpitation)

Adrenaline rush.

My right hands goes in, trying to scoop the buttock of the first twin out.

- No, way... Too deep... Ishk... T minus 2 mins before I call for Dr. M or extend the section -

Instinctively I scooped the head of the first twin and delivered cephalic.
Basically the baby sort of front-sommersaulted out with my manouvre.

- Phew... Definitely more difficult than delivery for tranverse lie -


2nd twin delivered uneventful.

Last check, both twin doing well.

I hope never again in my life to see another eerie hand.

It's really eerie.

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