So we were inducing this pt today for macrosomia, and I knew something was off when I first put her on the monitor. Now, I'm no expert, but I knew that I should not be having so much trouble tracing a vertex baby. Just really weird, oblong-looking tummy. I KNEW that baby was not in the right position, but I kept my mouth shut. MD comes to AROM, and baby is really high. Duh, right? Now, I'm thinking that she is going to say something about how this baby is positioned, and she doesn't. So I think it is no biggie. It was her 2nd baby, so if she was breech, they may have let her go vag anyway, right? Well, at 1515 this afternoon, after we had cranked up her pit to 28mu's (per order, of course) and she was still not contracting more than like 4-5 min, another doc from the group comes to see her and wants me to go with her to check her. So she is doing her vag exam, and she feels . . . you guessed it . . . feet! So we do an ultrasound and the baby sure is transverse. Version ineffective, to the back we go! They do the usual suprapubic incision, get to the baby, and her arm pops out. They stuff it back in. It pops out again. Again, it is stuffed in. Two docs pulling and tugging and cannot get a good hold on this baby. I swear, it took them 5 min to get the baby out. And I'm thinking, Damn, this baby is going to be all jacked up. They ended up cutting up vertically on her uterus, and then I'm not sure if it tore or if she cut it again diagonally to get the baby out. Apgars 5 and 8; baby did amazingly well considering. Her L arm was all hanging kind of funky, and the High Risk team called her clavicle "questionable". Breath sounds on the L, sats like low 90's. Baby does not go to the unit, but I swear to you, it did not stop screaming until we got it onto the breast in recovery. The most pitiful, raspy cry - I just know she had to be hurting. Whether something was broken or not, I do not know. So anyway, my question is: what do they do for a broken clavicle, if there is one? And why didn't I open my mouth when I knew something was not right???
Fortunately I still look young enough to be able to give them the Bambi innocent eyes when I say it so I'm believable..... If they only knew the truth eh!
Fortunately I still look young enough to be able to give them the Bambi innocent eyes when I say it so I'm believable..... If they only knew the truth eh!
Yeah, I just can't see it, knowing you as I do. :chuckle
Yeah, I just can't see it, knowing you as I do. :chuckle
steph
:rotfl: Yeah, I know. I sometimes surprise myself with what I'm willing to do for my patients :chuckle I am also famous at work for the passive agressive late night phone calls to the docs: "Oh, you don't think we need to do anything for the gas? OK, I'll just chart that I informed you of the gas and didn't receive any new orders, thanks.... Huh? Oh, you changed your mind and want to give bicarb? OK. Thank you doctor". (all of which is said in my sweetest voice, btw)
:rotfl: Yeah, I know. I sometimes surprise myself with what I'm willing to do for my patients :chuckle I am also famous at work for the passive agressive late night phone calls to the docs: "Oh, you don't think we need to do anything for the gas? OK, I'll just chart that I informed you of the gas and didn't receive any new orders, thanks.... Huh? Oh, you changed your mind and want to give bicarb? OK. Thank you doctor". (all of which is said in my sweetest voice, btw)
wannabeL&D73
110 Posts
Fergus that is brilliant!