Breech and broken bones

Specialties Ob/Gyn

Published

Hi all! My patient from last night is really stuck on my mind, so I thought I would throw a few things out to you all and see what you think.

24yo G1, 33wks. Breech presentation, history of bicornicate (sp) uterus, 2 cervix and lady partsl septum. PPROM at 11:30pm, came to hospital not in labor and was transferred to our undelivered/high risk floor. Got the call about 4:30am that she was becoming uncomf and was to be transferred to the LDR. I received her at 4:50am with a report saying she was just checked before leaving the floor and she is 1cm. Orders were to continue monitoring. A few minutes later, something didn't seem right, called out for someone to check her. No response. Did this a second time, then a third. Finally at 5:10, doc shows up....mind you, pt has only been in the room for 20 minutes......and is now fully! Ok, so take a deep breath and RUN for the OR.

Now, I'm not sure if this kiddo was frank or footling, but came out in a really strange posture. Not one I've seen before. Anyway, baby had really strange head.......ped's were thinking micro. I went into the nicu to check on her while surgery was finishing and guess baby had broken femur, possible broken arm and broken ribs.

What do you think? Result of presentation? Delay in delivery? Or something else like osteogenic imperfecta? It's got me a little baffled! Needless to say, I went back to the room and charted my BUTT off! But all day today, I keep saying to myself, could I have done something different????

Sorry so long! Any imput......good or bad....will be sooooo appreciated!

Joyce

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Couldn't tell ya, but this weekend we had a 32 weeker, footling breech precipitous delivery with clavicular fx and B/L arm palsy. HTH!

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Hard to say...it could be all the above (helpful aint' i).....i would check back in to see what is found. good luck!

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(Debbie, Living, Loving and Learning in Washington State ;-)

what part of washington are you in?

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Hey let us know what you find out, I am curious!

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

sue not far from seattle/tacoma!

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