I will try to keep this as brief as possible... I'm a nursing student who recently gave birth. I've have two other children so I'm no rookie, but there were several things about this birth that concerned me, so I got my medical records and fhr strip, and now I have some serious questions/concerns that keep eating at me. I would SO appreciate some experience/feedback, I want to know if there's any cause for concern and if my care was appropriate while I was in labor.
I have two concerns... biggest one is hypotension. After epidural placement, had some hypotension that passed after 20 minutes, not too worried about that episode. A few hours later, I requested a top-up. Right before the CRNA arrived, nurse put me on my back to check cervix, BP dropped to 104/37, then 106/42, now CRNA comes in and gives me more meds, BPs continue to be low, 98/55, 106/37. This went on for a total of 30 mins from start to nurse coming in and hanging new IV bag. Pressures immediately went up to 120/45, 112/44, then right back down to 108/45, 94/55, then not read again until 20 minutes later at 105/38. Twenty minutes after that last reading, the nurse came in and gave me an IV bolus, BP isn't read again until an hour later, 112/72. I was never given ephedrine and response time was 30-40 minutes with these ongoing pressures. I'm wondering if I should be concerned about my baby having some hypoxia due to these blood pressures. My normal pressure was 120/70. During this time period, my IUPC came out, so contractions weren't picking up, but my baby began to have some shallow decels, cant tell if early or late due to no contractions to compare. Variability decreases but stays 6bpm (moderate), and accelerations decrease and are almost absent for about an hour. Then, she comes on and off the monitor, the tracings I can see in between have moderate and some minimal variability, but this is after BP is resolved. It continues for quite a while. One more episode after this, nurse puts me on my back for 4 mins straight to check cervix, bp plummets to 120/37, and stays low for 20 mins or so.
After this 2-hour-long episode, someone else came in the room and suggested checking me for ketones. They didn't tell me why. I was fasting according to hospital rules, and they knew I'd been there for 13 hours at this point. Why did they check me for ketones? Do all laboring women who are NPO develop ketones, and what is the protocol for checking for them and administering dextrose? Mine came back large and they gave me dextrose.
So... was care appropriate? Should I be scared? Why weren't they worried? And is it ok to put patients in supine position after epidural? I thought that was a big no-no, how dangerous is this?
I would appreciate some feedback so much. I just want to know what happened, know if I should be worried.
Specializes in Education, FP, LNC, Forensics, ED, OB.
Thread is moving into asking/giving medical advice which per TOS, we cannot do.
To the OP, you need to pose all of your concerns to your OB and/or other healthcare providers. We sincerely hope you get the answers you need in order to resolve all of this.
CONGRATULATIONS on your new baby and hope you have a great holiday season.
sirI, MSN, APRN, NP
17 Articles; 45,878 Posts
Thread is moving into asking/giving medical advice which per TOS, we cannot do.
To the OP, you need to pose all of your concerns to your OB and/or other healthcare providers. We sincerely hope you get the answers you need in order to resolve all of this.
CONGRATULATIONS on your new baby and hope you have a great holiday season.
Thread closed.