Your freakiest OB patient? - page 2

I mean CLINICALLY freaky. I was reading about the pt with Sheehan's syndrome (never heard of it) and it got me thinking of the ones that have really stumped everyone over the years. If you're like... Read More

  1. by   nograd
    We had a patient once that was about to be sectioned for suspected chorio and unreasurring fetal heart tones. Mom had sats in the high 80s, rising BP, unsteady HR. Her nail beds were cynotic, lips blue, c/o increasing SOB and chest pain. This was ongoing throughout the pregnancy and was thought to be Rynaoud's (sp?) syndrome. The symptoms kept worsening while she was on the table and anesthesia was trying to get a good block. Anesthesia was afraid to put her under suspecting a possible PE (Rt. leg swollen x2 days, neg Doppler for DVT). VS continued becoming more unstable for mom and baby, ABGs done on mom PO2 80, PSaO2 88...FINALLY had a good block and went for it, got in and delivered baby, mom c/o increasing cp and SOB...situation very tense. Baby to NICU for acidosis, mom to get a VQ scan...neg & finnaly to ICU. Turns out baby had valitamous cord incertion SROM right along a large vessel, one more mm and the little guy would have bleed out. Two days later, I came back to hear mom was found in severe pulmonary edema/HTN with cardiomyopathy...she is awaiting a transplant, baby is doing good. Sad story, this was mom's first baby after many years of infertility (IVF).

    This is just one of the unusual patients we have had since I have been there. It seems that we have had weird cases for the past few years...strokes, amniotic embolism, PEs, a couple of cardiomyopathies(the first one just got her transplant a few months ago, her baby is still waiting, she too was in need of a transplant for anomalies), two Zanvarelli manuvous (good out comes)...It has been kinda crazy, but what a learning experience!!!!

    Do you all find that the IVF moms have more complications??? We have seen a string of them lately.

    Nicole,
    L&D RN 2B
  2. by   shay
    Originally posted by nograd
    Do you all find that the IVF moms have more complications??? We have seen a string of them lately.
    Without question. My IVF moms almost always have something go wrong. I see a LOT of preterm labor w/IVF babies and a lot of cardiac stuff w/IVF babies. Sad.
  3. by   mother/babyRN
    Gosh, there have been so many stories but the one that comes to mind was years ago we had a woman s/p c/s who complained of what we thought, was a spinal headache. Even the blood patch didn't work and it seemed, after awhile, as she was walking down the halls in tears, that her ob didn't really believe it was due to that. He called in a psych consult and the rest of us felt horrible knowing no matter what we did, she was in pain. Real or imagined, there was nothing we could do. Unfortunately, her baby was a little early and had been shipped. She stayed (DRGS not being as they are today) with us until, finally, after negative ct scans, she was told she had to go home or to a psych unit for further evalutation. Her OB had had it....He didn't want to listen anymore. We were at our wits end. We couldn't do anymore. She, about 2 days later collapsed at home and died. Seems she had a rare ca of the eye muscle that had gone undetected and the tumor was pressing on her optic nerve and causing severe headaches. We were all stunned. She never really got to see her baby because her vision was also failing. To this day her OB can't talk about it without getting choked up and we believe EVERY patient who has a headache...Many of the better lessons are so sad....
  4. by   nograd
    MB RN

    WoW! How unbelievably sad! And the CT scan showed nothing?? Increadably sad story....
    Do you know what happened to the baby?

    Nicole
  5. by   mother/babyRN
    baby went home with dad and did well, but sadly, never was able to be held by mom..Now her mom is her angel....
  6. by   Marj Griggs
    Patient with Eisenmenger's, 19 years old. Her condition wasn't Dx'd until 6 months, I think--too late for an AB (although I think she would have refused anyway). Hospitalized for quite a while-- delivered 4 or 5 weeks early. Baby did well, mom went to ICU and seemed to be doing well until her heart just stopped! They did everything possible to no avail. We were all devastated. A few months later, another patient with Eisenmenger's, but not as severe (this one wasn't cyanotic & didn't require O2), had a normal delivery and went home with her term baby.
  7. by   mother/babyRN
    What is that syndrome Marj? I am unfamiliar with it..How sad...
  8. by   joyrochelle
    well it's not all that freaky...just kinda interesting...perhaps well known as well, but here goes...we had a string of patients come in this week with Bell's palsy....pregnancy induced....apparently it's caused by a herpes virus, and the stress of pregnancy triggers it!

    so we had patients with frozen facial features unilaterally....I found that interesting.
  9. by   obtnt
    My pt is not as interesting but here goes; Mothers Day and every Mother to be is in L&D. I'm charge and every high risk pt in TN is being flown in to our facility. I had a pt with contractions, first baby ( I think) and we were just observing her. The dr finally decided to send her home after her contractions slowed way dn. I was admitting another high risk pt and just looked up at the monitors and could not believe what I saw... a straight line down and off the page!!!! I ran to her rm to find the techs, the dr (THANK GOD he was in the station and saw it happen) and the US machine which revealed no fht's!! I jumped on the bed, inserted a foley en route to the section rm and we crashed her on the spot. We delivered a healthy baby that needed a little help but did ok considering. I will always wonder what happens to this little guy in the future since we obviously caught a stillbirth

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