What's your most interesting/scary case?

Specialties Ob/Gyn

Published

We all know that working in this field can be exciting, touching, heart warming as well as heart wrenching. We know that strange and exciting things happen everyday. But every now and then something really strange, very scary and/or rare occurs. I think this might be a good opportunity to learn from other's about their most strange/interesting/scary experience. I have two:

1. Primip, uncomplicated term pregnancy, had good PNC. Came into triage in labor, 4cm I think, intact membranes, good strong ucs. Pt admitted, 0 epidural, got to C/C/+2 station, doc was called to come for delivery. MD showed up and ruptured membranes......BLACKish/Brownish fluid came out. Baby born in severe respiratory distress, transferred to NICU. Infant dx with severe Primary Pulmonary Hypertension and the baby died. Apparently the OB theorized that several days prior to delivery a blood vessel on the fetal side of the placenta broke and bled into the amniotic fluid. The infants lungs and stomach filled with this old bloody fluid and the infant was unable to be ventilated. Very sad case.

2. Multip, 37 weeks, good PNC, had numerous ultrasounds due to absent fetal movement on the ultrasound however everything else looked good except mom had bigtime polyhydramnios. AFI 59:uhoh3: , for the life of me I can't figure out why she wasn't admitted at 36 weeks(UH...hello doctor, isn't this a prolapsed cord or abruption waiting to happen???:smackingf ). Anyway she came in soaked from her waist down and in a lot of pain, EFM applied (baby looked good), 3 cm dilated. All of a sudden she had a complete abruption, blood pouring out, baby heart rate plummeted. Mom rushed to OR, not even an IV yet. Mom was crash sectioned, baby came out dead, but resucitated. Baby had neurological defects, no movment, no swallowing(hence all the fluid). I don't think the baby made it. It was so scary and sad for the family because they walked in and 11 min later baby was delivered, they didn't speak english and the only spanish speaking person on the floor was in the OR already. They had no clue what was going on.

Specializes in NICU.
i wasn't there, but heard about it later.

young couple, 20's, first baby. healthy pregnancy, term, nearly 8 lb. girl. mom was pushing. of course, there's always that point where you lose heart tones, but delivery is moments away. the cord somehow tore as mom was pushing baby out. by the time the doc could clamp what was left hanging, baby had bled out. neo team worked on baby for over an hour, but couldn't save her. there was just not enough blood left in her body for the rescusitation efforts to work. (not sure if they transfused, but if so it was obviously too late to do any good)

...and this is why i should stop reading this forum. :(

Specializes in Looking for a career in NICU.
This is the most frustrating part of OB nursing for me. Why don't pts get PNC!!! You can get it at free clinics and they help you sign up with MediCAL. I had a 17 yr old pt the other day deliver a 28 weeker that had no PNC. And this was her second baby, and I know with her last baby only 1 yr ago she was given PNC information. This delivery was at my other job which is at a small rural hospital. Thank God the baby did okay til the helo arrived. I wish more education was made available to these people that don't seek out PNC. Afterall its not the baby's fault.

It's always tragic to hear stories like that. I often wonder of the babies that don't make it due to lake of PNC.

I have a friend who's neice has a 2 year old, and has never had a stable job, or a stable place to live since that baby was born. I swear I don't know where she gets the money to eat. She just drags the child from this house to that house when she gets kicked out of somewhere, and I heard that she is 5 months pregnant again and refuses to give the baby up for adoption.

It's just so sad.

Specializes in Looking for a career in NICU.
I know that in my area, the reason many immigrants don't get prenatal care is that they are illegal and don't want to get deported. Plus the ones who are here legally often don't know about the free medical care available. I think prenatal care is very very different in other countries, too. We tend to overdo it in the US, no? I mean, yeah it's a good thing, but not every country has the same resources for prenatal care and it's normal for some women to not have any.

They have a huge problem with Hispanics here "making" their own baby formula out of Carnation milk, which if you are an "old school' nurse is a think of the past.

...And this is why I should stop reading this forum. :(

Okay, some has to tell some funny stories too. We don't want to lose our loyal readers......due to all depressing stories.....

Specializes in L&D.

Ok.... a positive story.

A lovely, lovely couple, having baby #1. A true May-December romance - and I got to hear the entire story of how they met. He was more than twice her age, and was her recruiter in high school for ROTC. He successfully recruited her to ROTC, and once she was of legal age, she worked at wooing him over! It was actually very cute, how they talked about it. He ended up transferring off of her case as her recruiter, so they could begin dating.

They overcame multiple obstacles to get to the wedding day (including the priest who thought they were *too* compatible, even after almost a year's worth of pre-marital counseling).

I was just sad that I couldn't stay on a whole shift beyond mine, to see them through on the delivery of their first child.

They were a very loving, funny, entertaining couple to care for while in labor. The stories they told....just beyond expression! I won't repeat them all here, and I did change some details, to keep their privacy.

Specializes in Looking for a career in NICU.

My grandma told me a story once that fell under the catagory of "sick".

A mother, brought her 14 year old daughter, who was very heavy set to start with, into the ER. My grandma knew instantly the way the young girl was arching her back she was in labor, and brought her a wheelchair immediately.

The mother snapped at my grandma,"I have taken her to doctors within the last 2 DAYS and they say she is pregnant, but I'll have you know my daughter is still a virgin! So that can't be!" As the daughter, remained quiet..

Her water, miraculously broke at 2 minutes after she finished her sentence, and then even the mother couldn't even deny what was going on. The poor girl went on to deliver a healthy baby boy.

The girl was obviously scared to death of her mother, and my grandma went in to talk to her and that is when the sickest part of the story was revealed...she had been raped by her 17 year old brother.

My grandma called DSS, and then called the mother. The mother called her son to come to the hospital when he got out of school.. My grandma was expecting to see some nerdy, homely, socially outcast kid walk down the hall, but instead she saw a guy that was drop-dead gorgous.

Here he could have anyone he wanted for sex, and he had to abuse his little sister.

They actually kept the baby. She never knew what happened to them after they left.

Specializes in Case Management.
Weirdest case for me in recent memory was a G2P1 at term, 1st baby was a c-section, 2nd baby successful VBAC. Nice delivery, variables at the end but she was complete & pushed the baby out quickly. Happy recovery, breastfed, mom & baby stable. We took mom back for a postpartum tubal about an hour after delivery and when they opened her abdomen discovered vernex in there. It quickly progressed to an fully open abdominal hysterectomy, many units of blood, ICU stay for mom.

I just keep thinking if she had gone out to the floor & had her tubal scheduled for later that morning....

???What happened? (I don't get it)

Specializes in NICU.

There was a baby that was about 2 days old that had been up in Mom's room. The PP nurse was preparing to send Mom and baby home when she happened to notice that the baby (who was happily BFing) looked a bit dusky. Hard to tell since the room was a bit dim in the first place. Assess baby, contact ped, transfer to NICU, cardiac ultrasound...

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Yup, Transposition of the Great Vessels. His PDA was just starting to close and that's why he was getting dusky. Had it completely closed, well then....:sniff:

Specializes in NICU.
There was a baby that was about 2 days old that had been up in Mom's room. The PP nurse was preparing to send Mom and baby home when she happened to notice that the baby (who was happily BFing) looked a bit dusky. Hard to tell since the room was a bit dim in the first place. Assess baby, contact ped, transfer to NICU, cardiac ultrasound...

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Yup, Transposition of the Great Vessels. His PDA was just starting to close and that's why he was getting dusky. Had it completely closed, well then....:sniff:

This is what's so scary about these 24-hour hospital stays. There are quite a few congenital heart defects that go undiscovered until the PDA closes. If that doesn't happen until 24-48 hours after delivery, and the baby is already at home...

We have recieved quite a few of these kids in the past, admitted through the ER in critical condition. They typically don't do as well as the kids who go straight to the NICU after birth and put on prostaglandins to keep that PDA nice and open until they can have surgery. During my last ultrasound, one of our perinatalolgists was telling me that hypoplastic hearts scare her the most because the heart looks normal up until 20 weeks and then it stops growing properly. Well, since most low-risk pregnancies involve ONE ultrasound at 18-20 weeks and that's it...you can imagine why so many go undiagnosed.

Specializes in OB.

We are all sitting around the nurses station one slow night and we hear screaming and pounding at our locked unit door. We all jump up to see a mom clawing at the door. We then open the door, she is obviously about to deliver. The midwife who was sitting at the desk with us also comes running. We tell mom to sit down on the floor while we get a stretcher and instead she pulls off her pants in the hallway, well as she does this the baby comes right on out, falls to the floor, as the midwife is trying to catch it, the cord breaks, blood starts spurting everywhere, did I mention the baby had THICK mec. All of this with NO GLOVES. The mom and baby were fine, dad came running up a few minutes later, He just dropped her off at the door, and went to go park the car. We now have a permanent stain on the carpet as you walk in the door, no matter how many times it is cleaned there is still a "mark" from that night. Rule to remember....always expect the unexpected!

Another night we get a call form the ER, mom is about to deliver in the ER and they need us to come get her. We go running down with all of our stuff, mom is on a stretcher in the resucitation room, baby on her chest, crying, wet with no blankets. The ER staff is bagging the obviously pink crying baby. Not the people that you want at your birth, a heartattack or a trauma yes, but birth is definately not thier thing!

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
???What happened? (I don't get it)

I'm guessing amniotic fluid embolism, which turned into DIC?

???What happened? (I don't get it)

She ruptured her uterus at some point (which is why there was vernix in her abdomen) but small enough that she was stable until we got back for the tubal. And then she quickly deteriorated. But did recover & went home with a healthy baby.

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