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Re: TAH in 18 yr oldFrom: Ari Gold (arig@getnet.com)Fri May 29 16:05:21 1998
>Date: Thu, 28 May 1998 23:59:45 -0600 >From: shiraz suleman <suleman@sk.sympatico.ca> > >I had to do a TAH ain a 18 yr.old 5 nights ago.A case from hell. >Delivered by family physician at 1900h.I was called to dsee the patient >because of persistent bleeding. >1930h.I was in the room. >2015h Arranged for OR. >2100h.Discussed with family. >2200h.Uterine artery ligation and patient still pouring blood. >Anaerthetists were sweating. >23h00.Decison for TAh.Uneventful hysterectomy. >I wonder what a home delivery would be like in situations like this. It sounds like you did an excellent job and are to be commended. In answer to your question about home deliveries, I think the course would have been pretty much the same. Once it was established that the mother was continuing to bleed, the midwife would have called her consulting physician and explained the circumstances and transferred the mother in. It is likely that by 1930 the mother would have been in the hospital, seeing the OB consultant, the same as with your case. Just because a woman begins at home, please don't assume she stays there when there is a complication! Most homebirth midwives are prepared to use IV's, pitocin, methergine, and hemabate at home when indicated for postpartum hemorrhage. If the hemmorhage continues despite these attempts (and of course bi-manual compression), then of course the mom is transported. Thanks for asking.
>Dr.Shiraz Suleman Ingrid Gold, CNM arig@getnet.com midwife at over 1200 homebirths in the last 20 years
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