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Difficult Delivery: What Went Wrong?

From: lauren (anonymous@obgyn.net)
Tue, 13 Oct 1998 08:56:47 -0500 (CDT)


I had a very difficult delivery the first time around, and my son ended up in NICU with a pneumothorax, troublesome pH level and and a stiff neck. He's fine now, but I am very concerned that the same thing not happen again in my current pregnancy. Can you help me figure out what went wrong?

I am 5 feet tall, and had a HUGE belly. I was 9 days late, the baby hadn't yet dropped, and my cervix had no signs of ripening. I was scheduled for an ultrasound to determine the weight of the baby, but I went into labor on my own that very day. I was progressing very nicely, and didn't want an epidural. But at 7 cm, the baby STILL had not dropped, and the doctor advised me that I should really get an epidural to relax my muscles to allow the baby to drop. He warned me that if the baby didn't drop, that was a sign that the baby was too big to come out vaginally. So, I got the epidural.

Immediately upon getting the drugs, the baby dropped, but my labor stopped completely. So they gave me pitocin and a fetal scalp monitor. Several hours passed with no progression. Now the doctor told me that if I didn't progress to 10 cm by 3:00 p.m., I would have a c-section because it was a sign that the baby was too big to come out vaginally.

At 2:50 p.m., I reached 10 c.m. By then I had no feeling in my legs and no urge to push. I asked them to turn off my epidural, and they did. I started to push, but nothing was really happening. Now the doctor told me that he would use the vacuum to cause pressure but not to pull the baby out. He told me that he could not use forceps on me because he was concerned about a high risk of shoulder distocia. The vacuum fell off several times, and I was in excruciating pain, felt like I was being ripped apart and set on fire. There was a huge resident applying fundal pressure, and the room was filling with doctors and nurses. Eventually after 2 hours of pushing, I popped out my 7 lb 5 oz son, with such force that there was no time for an episiotomy. In the last few crazy minutes (or so) of pushing, my fetal monitor fell off, so we don't know if my son was in distress.

I heard the doctor yell "cord!" and my husband saw him lift the cord from around my son's neck. My son's cries were very weak. His head was bloodied from the vacuum. And they suspected that he had swallowed or inhaled meconium, and so they suctioned his lungs, which I THINK caused the pneumothorax, but I don't know.

Anyway, they rushed him to NICU, and it was very traumatic for us. But he turned out fine and he left NICU within 21 hours (only to end up with moderate jaundice, probably as a result of the head trauma).

Can someone tell me what went wrong? Can anyone tell me what we can do different next time? My parents are telling me that I should schedule a c-section. True?




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