I came up with this solution for a broken bed at about 4 AM while we were getting ready to do a cesarean section for a patient with placenta previa who was having a hemorrhage.
Patients with placenta previa have the placenta down low in the uterus so that it is covering the cervix. That means that the placenta is between the baby and the exit. When the cervix begins to open and the baby wants to come out, the placenta begins to bleed so that both the mother and the baby are at risk of death. It is a medical emergency in obstetrics. This case was complicated by the fact that she was only 33 weeks pregnant when she started to hemorrhage (2 months early), and she had a history of three previous cesarean sections.
Even in the absence of the emergency, doing a cesarean section on a patient who has 3 previous lower uterine scars makes me nervous. These patients often have lots of scarring which can make the surgery very difficult. In addition, in the case of placenta previa, the placenta is often stuck to and growing into the previous scars which can lead to different type of surgical emergency in which the patient ends up with a hysterectomy.
I pray a lot when I am standing next to patients like this.
We have scriptures up on the walls in lot of the operating rooms. This room in particular has a scripture hanging right in front of me when I am standing by the patient’s side getting ready to begin. I will look up at it, and I will pray for my patient and for myself. And when all is over, I will look up at it again and thank God that his promises are true.
She did great!