Just returned from the hospital, I’m not sure whether I have made a right decision. It was Thursday night, evening before the Prayer Day, Friday. We gathered in one of our staff house for a “kat” gathering. It serves as a social function for local people. All together we have twenty of us in the party. While we were enjoying and chatting, I received a call from Emergency Room. They told me there was a woman admitted with abdominal pain, and convulsion. When I was there, I found that it was a full term pregnant woman in labour. But her blood pressure was high, and in semiconscious state with convulsion. I diagnosed her having eclampsia (pregnancy with high blood pressure). The husband and a woman relative did not know she was pregnant until I showed them the foetal heart beating, not even the Emergency Room doctors. It was her first pregnancy. But I told them it was very dangerous for both mother and baby. I started her on some anti-convulsant and anti-hypertensive medication. I called Jorg and the midwives to help. When I was considering whether to go for the Cesarean Section (operation for delivery ), I found that the baby head was already engaged in the cervix. So I immediately decided to have a trial of labour. All the time I checked the baby’s heart beat was alright. Later on, I found that mother’s pelvis was narrow, it would be difficult to have vaginal delivery. But I found the baby’s heart rate was normal and there was progress in labour. I tried using the vacuum extraction to help. Unfortunately, it took a longer time than expected. It might be due to the anti-convulsant (Mg sulphate).I used causing the uterus contraction less effective despite we already gave medication for helping the contraction. We cautiously checked the baby’s heart beat all along. It was stable. Finally we delivered the baby, but she was in very bad shape. We resuscitated her but failed. The baby girl died. The mother blood pressure came back to normal after the delivery. Unfortunately, we lost the baby. Father accepted the outcome and he was happy mother was safe. I was so regretted that I should have the C-section early. In fact, the midwives did ask me about C-section. I told them if we could deliver vaginally, it would reduce most complications on her either in this occasion and later delivery. If I decided to open up early once the progress was not satisfactory, we might have saved the baby. I was very upset. I hope it won’t happen again. Sorry!

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