Uterine Explosion

The funny thing with Labor and Delivery is that there is always something to recount. Whether I actually sit down and write or not. Sometimes I'm so tired when I get home that I plop myself down on the couch, too tired to even eat, and veg. I've been doing that for the last few shifts.

Now that I've been off a couple of days, here's my most exciting moment of the last week: It was one of those days when you're already short-staffed (because it's a guarantee that brown matter will hit the fan on those days!) and the unit was almost full. A hurricane was closing in on us and the weather changes were causing all kinds of Preterm Labor issues. I was running from one room to another, doing the job of several nurses when out of the corner of my eye I caught a glimpse of someone running. This is never good in Labor and Delivery. It's a terrified Husband with his Wife in a wheelchair. Wife is gripping the arms of the chair with both hands, holding her butt out of the chair, her entire body is stiff as a board. Yikes. All classic signs and I don't have time for this right now!

I head them off into the closest empty room while drilling them with questions. They barely speak English. All she could say was "Pain! Pain! Pain!" From Husband I quickly gather that she is about 31 weeks pregnant and having contractions. I help her stand up and an enormous gush of blood spills down her legs. CRAP. I batter the poor Husband with questions to find out she had a previous cesarean section, the pain is constant and worse with contractions. A picture is beginning to form in my head: she's abrupting (the placenta is breaking away from the uterus) or her uterus is rupturing (at her previous c-section scar) probably because of preterm labor. The baby's heartbeat is dropping with each contractions. Despite the bleeding, I decide I have to examine her. She's almost ready to deliver but I can't feel what part of the baby is presenting because of a bulging bag of water. I need help.

I call for help and the troops are rounded up. Within minutes everyone I need is present. The Obstetrician does a quick bedside ultrasound to find out that baby is breech and must be delivered by c-section. We run to the operating room and quickly prepare for surgery. As soon as the Obstetrician cuts into the patient's belly, blood gushes, uncontrolled. She quickly gets baby out and we are able to get a closer look. The patient's uterus has ruptured. Now I've seen many ruptured uteruses in my time. This was the ugliest I have ever seen. It was like a bomb had gone off inside. Hamburger meat. For hours, the Obstetrician worked on the Patient, controlling the bleeding and sewing the unrecognizable muscle back together. She deserves a medal for her skill in saving that uterus. I don't know how she was able to sew it back up.

How did baby survive? By some miracle, the placenta, delivering food and oxygen to the baby was located on the back of the uterus and was never affected by the gaping wound in the front of the uterus! Reports from NICU said Baby was doing wonderfully.

Many, many times I leave work thinking "Thank-God!" In Labor and Delivery, one event or another always seems to work together to lead to miracles, big or small. This was a big one.