::--emergency day--::

somehow i feel like going to OT n observe the ceasarian section today...

i was about to go back after having observed one case....but the next case are flexed breech....my heart says that i really should wait for this case....

everything going fine....until the baby's head stuck...and J section has been made...yey...i've witness the J section....

after delivering the placenta....suddenly there were very massive hemorrhage(bleeding)...(i see it from the sucker =p)...

blood lost at that time were >500ml...which indicate the post partum hemorrhage(PPH)....obtetric emergency!!!

i just learn about PPH yesterday...and gladly, i manage to see life action in front of me...

red alert initiated...consultant(i think so) are called, blood being ready....

large bore branulla inserted...blood tranfuse....uterine massage started, then uterine packing with hot abdominal pack...unfortunately the hemorhage doesn't want to stop...

when the consultant arive...consultant taking history(any abortion?....any multiple partner?....but i guess the patient CANNOT BE TRUST...as she denies that she does not knows that she pregnant...she claim that she does not know how she could pregnant)

Hb at that time were 7.4g/dl. Then manual removal of any tissue takes place...but nothing....placenta check...and all the cotyledon complete...

after vigorous packing and injection of pitocin and lastly heamabate(carboprost)...the bleeding stops slowly....

alhamdulillah....there is no uterine artery ligation...or hysterectomy(removal of uterus)...im very afraid when the consultant as the nurse to call up her family...as the patient is only 18...furthermore...she are still UM...

total blood loss = 1000ml in sucker + 30 over gauze soaked + 18 abdominal pack soaked = total up about 2 liter of blood...

bleeding is coming from the fundus and nothing to do with the J section

almost 2 hour of standing...it is worth it

adeiz : there maybe lot's of spelling mistakes....sorry