9/19th Catch

10/25: Night Shift... My patient (21 yo, first timer) came in 5-6cm dilation at 8pm with normal vitals. When she was endorsed to me, heart tones were tachycardic (160>), which was easily fixed by Left-side lying and drinking water. Since one of the 1st years needed a labor watch, she checked vitals for me throughout her labor. Interestingly, heart tones would plummet through a contraction, and bounce back to normal afterwards.

At 11:30pm, my patient went from laboring well to vomiting up water, which she proved not to be able to hold down. She kept feeling like she wanted to push, but we knew she wasn't ready yet, and so encouraged her to breathe through contractions and  do labor stimulation.

Around 1:15am, she was starting to get exhausted, from battling the contractions and not relaxing through them, so we gave her aD5LR IV, to give her more energy. I then did an IE, which showed she was 9cm, and almost ready to start pushing. However, upon next FHT, we found heart tones had dropped to 70/80bpm, and we almost gave her O2, except that they bounced right back up after the ctx was over.

Then, BOW became visible while doing hands and knees, so we put her on the antipolo and encouraged her to push. "Khent Ruberth" was born at 2:53am in the caul (the water bag), with a nuchal cord. Talk about an interesting birth!! Boy, was that amniotic membrane hearty!! Trying to rip through it with gloves and get the cord over the baby's shoulders (since it was loose enough), took a few seconds.

APGAR Scores were 7,8, and the EBL was only 200cc. She did have a 1st degree tear which one of my Ate´s sutured...but after talking to my supers, I guess they were expecting quite a bit worse, and that the caul aided things tremendously. (Though I have to add, that it was a little scary in some respects too, partially because it is so slippery, and you're expecting it to burst in your face in your face--even with careful guarding. ;)

Khent weighed 5lb 5oz. and was 20.5" long. Another successful birth, and another variation learned. Praise God!!