Friday, April 4, 2008

You too can have a vaginal delivery.

Unintended vaginal deliveries......that seems to be the theme for this week.
We had a patient scheduled for repeat c/s on Tues morning who came in saying she had not slept all night d/t an upset stomach and constipation (this pt is also an MD). The patient kept insisting she really needed to go to the bathroom, she said she just felt sooo bloated and constipated. The monitor showed she was contracting q3 minutes and they were palpating strong, but she kept denying even feeling them. She had only been there about 20 minutes and had refused a vag exam because she didn't think she was in labor. Finally the nurse absolutely insisted on a vag exam to evaluate and let her MD know what was happening. Well, turns out the gal is complete and +2 with a BBOW. She ends up with a precipitous VBAC (RN caught baby) and mom and baby are both doing great.

We had a G1P0 come in on Thursday morning for a scheduled primary elective c/s for suspected macrosomia. Turns out she had SROM a few hours prior to her arrival and since she was already contracting regularly decided that she wanted to attempt to labor and deliver vaginally. She did wonderfully, got an epidural @6cm and once she was complete labored down for about an hour then pushed for 35 minutes to deliver a very robust 9#7oz bundle of joy. Her labor was a total of 12 hours from the time her water broke and she started contracting. Not bad for a primip!
Guess they got the macrosomia right......too bad there isn't a little more trust in the body's ability to birth the baby that it grows.

We have had a surprising number of vaginal deliveries this week compared to what we usually have when the census is as high as it has been. Hmmm, maybe I need to check our stats for this week. The less time I spend in the OR the happier I am!


Permission to Mother said...

What's BBOW?

RN2CNM said...

Sorry, that is bulging bag of water.
I think I will do a post on all of the acronyms, abbreviations, and other such lingo that is used in labor and delivery units.