Manual extraction

  1. I don't think my anything I have ever seen in my 10 + years in heath care could possibly compare. not even my 3 years on the ambulance and the truma I have seen. It was awful

    This was my first manual extraction. the patient had been with us for 4 days for PIH. she was in her early 20's and sweet as can be. she did have a low pain tolerance but managed to deliver a butaful 8.9 baby boy without pain meds (as she had hoped). Atfter the other nurse handed her the baby she looked at me and said "I did it DayRay I did it" my heart melted I was so proud of her.

    I had stoped her pit and was waiting for the placenta so I could turn it back on. I waited and waited ..we waited 35 minutes and it never seperated. I recived orders for demerol and versed. set up the pulse ox and put her on a littel o2, pushed the demeral and then the versed.

    I knew it was painful but never had any idea how bad it could be. I had to hold her down while she cried and screemed and begged us to stop. I have never felt so terrible It was like watching her being raped. when the doctor got the placenta out I went into the hall where I saw her mother and husband they were crying. I huged them and told them she wouldent remember the pain . they just looked at me.


    thank you for letting me vent =)
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  2. 24 Comments

  3. by   ShandyLynnRN
    YOWSER!

    I have actually seen a doc remove a placenta with nothing for the pain until afterwords. Talk about brutal!
  4. by   KaroSnowQueen
    When I had my third one, the baby's head was just starting in the birth canal, and the cord was so tight she couldn't go any farther. The doc reached up with both hands and pulled baby and placenta both at once. I had an epidural going and it still hurt!!!!!!!!!!!!!!!!!!! And I remember it still, that was over 19 years ago.
    I did heal up just fine, better than with the other kids and got a good healthy intelligent baby out of the deal, so didn't hold any grudges. HOWEVER, if it had turned out badly, I think I would feel much differently about the whole experience.
    WHY would a doc do this without pain medication, as Shandy said? Are they crazy? Sadistic? Thoughtless? Looks like they would be afraid of lawsuits.
  5. by   SmilingBluEyes
    I saw one on a poor lady have to have manual extraction of a stubborn placenta w/o benefit of anesthesia. It was weird; she was a 25 year old healthy G3P2 and had NO risk factors that would make anyone believe such a problem would occur.

    Fortunately, the MD was kind enough to call Anesthesia personnel and arrange conscious sedation to make it easier for her. Still, she moaned and groaned a bit when the manual extraction of her very fragmented placenta was happening. The doctor pulled out no fragment larger than a quarter. It was laborious and awful. Yes, it was a gross, horrible thing to see, making me shudder from head to toe. We had PLENTY Of cytotec waiting for immediate administration following the extraction.

    And, thankfully, the patient neither remembered any of the procedure nor did she hemorrhage at all. The MD was very skillful and thorough in the extraction and we were very vigilant for any complications afterward. Luck and skill; those worked together in favor of this lady. I will never forget the images, though. OUCH.
  6. by   renerian
    OMG I am horrified...............

    renerian
  7. by   OBNURSEHEATHER
    Ditto that renerian. I have, thankfully, never had to witness this procedure.

    Heather
  8. by   frannybee
    You know when you hear about some procedures that make you just a teensy bit scared to move into a new area of nursing? This is one of them. :stone
  9. by   renerian
    Franny I agree that would scare me..............I don't scare easy..........gulp.

    renerian
  10. by   mark_LD_RN
    i have witnessed this procedure a few times yes it is pretty brutal. last one i saw done they just gane her 50mg demerol 25mg phenergan iv and did it. she was a tough girl she took it very well.
  11. by   sbic56
    I have seen a different response to manual extraction procedure from each woman I've assisted with. I can remember one that just gave sort of a grimace through the entire thing. And, then, like Dayray's experience....eeeek!! This is not one of the high points of OB nursing!
  12. by   canoehead
    I saw one, as a student, and that was the only time in my nursing career that I felt I might pass out. It was brutal, and the woman was begging the doc to stop for 30 min or more. I still don't understand how he could do that, or why no one stopped him so she could be put out.
  13. by   SmilingBluEyes
    Originally posted by canoehead
    I saw one, as a student, and that was the only time in my nursing career that I felt I might pass out. It was brutal, and the woman was begging the doc to stop for 30 min or more. I still don't understand how he could do that, or why no one stopped him so she could be put out.
    Perhaps it was an emergent, life-or-death hemorrage situation? Just a guess. I agree, it is a brutal thing to do to an un-medicated or un-anethesized woman, period.
  14. by   NurseyNursey
    I had a manual extraction after I miscarried at 17 weeks. I had some Stadol, but it was still horrendous.

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