Mom and Baby Were OK
When I was an anesthesia resident, a pregnant woman came into our medium-sized community hospital in the night with some abdominal pain and nausea.
Her doctor determined she was not in labor so we just treated her with medication and kept her overnight. In the morning, a new obstetrician started daily rounds. When he saw her, he immediately raised the alarm.
The new obstetrician noted that the patient’s blood pressure had dropped. They felt the patient’s uterus and it was exquisitely tender. At this point, our patient is feeling very faint.
Now the diagnosis is likely a uterine rupture, which is when a small hole has burst in the womb. In these cases, the solution is an emergency C section, and my team was called in to perform this delivery.
A uterine rupture is bad enough, but when we removed the tiny preterm baby, we discovered a horrific truth. It wasn’t a rupture but a placenta percreta.
That’s when the placenta grows through the wall of the uterus and into the surrounding organs, in our patient’s case her bladder. The surgery became more complicated and we had to call for help.
In the OR we now had a urologist, and two other anesthesiologists and started a blood transfusion as she had lost a lot of blood. This condition is usually detected on a prenatal ultrasound, but the patient had skipped hers.
If she hadn’t missed it, this surgery would have been performed in a big city due to its risky and delicate nature. Thankfully, mom and baby were OK. TableWallFurnace