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Ask Monika Hearne, M.D. Your Own Question
Monika Hearne, M.D.
Monika Hearne, M.D., Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 5180
Experience:  With experience and compassion, I treat my patients like family.
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Fairly complicated situation relating to my wifes delivery,

Customer Question

Fairly complicated situation relating to my wifes delivery, Summary as follows: 2 prior pregnancies on first but assisted natural birth resulting in 3rd degree tear and haemorrhaging. Second Elective C/S on basis of advice due to size of first baby, tears and varacosities, 3rd recommended C/S. Waters broke 5.30, delivery suite arrival 7.15 assessed as C/S urgent as 6cm dilated, 3m regular contractions 10.10 fully dilated Terbutaline administered with no affect bar one contraction. Transferred to theatre 10.30, spinal completed 10.40, Knife to skin 11.04, Knife to uterus 11.06 birth 11.07 placenta delivered 11.09. Blood recovery was performed and this autoinfusion recovered 120ml of blood. Notes no foetal monitoring between 10.45 and birth (22mins) placenta positioned to front. Readmitted 2 days after discharge with sepsis requiring laparotomy, collection before hand described as faecal post CT scan matter however hospital did not swab but notes state not faecal rather fiborous, gassy, liquid collection. After effects, 3rd degree lateral tear to uterus extending into cervix, repairs done externally. Damage cause to left ureter via suture puncturing and constricting this later led to vaginal fistula. This required reimplantation of the ureter into the bladder whic is now complete. Areas of concern, notes confirm difficult dis-impaction, I remember them stating at examination on arrival that the head was showing and I recall the OB Consultant telling a nurse to push my son back up whilst spinal was being inserted. So questions: 1) How long is it normal for a disimpaction to take, do you believe it is reasonable to achieve in less than 1 minute? 2) How likely is a stitch through a ureter in the circumstances described? 3) Do you think and plan to push the baby back up would have been documented by the midwife or doctor? 4) How do you disimpact without pressure from below in the circumstances 5) Given the circumstances what do you feel is the likely cause of a collection in the peritoneal cavity post c/s where the bowl is not perforated, the ureter at this point is not leaking and there are no other sources of material present? 6) notes state extensive bleeding is this commensurate with the amount of blood recovered ie 120ml? Thank you

Submitted: 2 years ago.
Category: OB GYN