A memorable mum…

Friday week ago, started like any other morning at the hospital. We had devotions, and then began our clinical hand-over at about 0800hrs. David Friend (the senior doctor here at Mukinge) had been on call on Thursday night, and told me about a mum on maternity. He said she was 14 years old, in her first pregnancy, and had a seizure (eclampsia) at about 0430hrs. It also seemed that she had a fairly big baby from the size of her abdomen. After treatment for her seizure with magnesium sulphate, she had settled well, and was progressing in her labour. The hand-over to me (the doctor looking after maternity during the day), was that she should be delivered soon, and to keep an eye on her.

On arrival on the labour ward, the young mum was unfortunately not yet delivered, but was progressing well (with only 1cm to go until she could start pushing). She still had some of the signs of eclampsia, so I decided to continue her magnesium injections and review her again in an hour.

When I returned to check-on her, the poor girl was not progressing, and after review by our Zambian medical officer (Menda), we decided to take her for a c-section.

In theatre, I began scrubbing to assist Menda with the c-section, while our senior nurse-come-anaesthetist (Lynn) was about to give the girl a spinal anaesthetic. My scrubbing was interrupted by a commotion on the operating table where our patient had begun to have another seizure, just as the spinal was about to go in!

Following some diazepam and a quick anaesthetic, our c-section began stat. Menda is a fantastic surgeon, and he quickly had the baby out. The boy appeared no worse for wear, and was quickly passed off to Lynn (our nurse-come-anaesthetist-come-paediatrician). I was still looking over my shoulder to see how Lynn was going with the baby when Menda let out a cry – “and another one!” Shortly after, a healthy second boy came into the world. 

Mum actually had yet another seizure while she was being closed up, but fortunately settled well on medications over the next 24 hours (delivery is the best treatment for eclampsia). I discharged her and the boys home late last week, for what will no doubt be some challenging and busy days ahead. - d