AFTER DARKNESS COMES LIGHT

Obstetrics & Gynaecology

 

A 40 year old lady had been presented in the Emergency department of Ruby GeneralHospital with complaints of preterm premature rupture of membranes for last 7 days at 27 weeks of pregnancy. The lady had been admitted under the care of Dr. Ayan Mukhopadhyay (Consultant Obstetrics & Gynaecologist) and Dr. Aparupa Ghosh (Consultant Obstetrics & Gynaecologist) and after relevant investigation, the USG report revealed nil liquor. The consultants were faced with multiple challenges, on one hand there was a possibility of chorioamnionitis (A serious condition in pregnancy when the membranes that surround the foetus and the amniotic fluid are infected by bacteria), extreme prematurity along with nil liquor and on the other hand there were every chances of foetal respiratory distress due to immature lungs. The problems became manifold when the patient’s blood sugar reported as high as 370 mg/dl, thus, increasing the chances of an already ongoing chorioamnionitis. After a detailed discussion with the family members and in view of nil liquor an emergency caesarean section had been done. A live baby weighing 1240 gms had been delivered. The baby was active and cried at birth, but, needed Continuous Positive Airway Pressure (CPAP) support and had been kept in Neonatal Intensive Care Unit (NICU). The real challenge for the consultants had been taking out the infected placenta adherent to the uterus and thorough cleansing of the uterine cavity. The postoperative period had been uneventful and the lady had been on intravenous antibiotics for chorioamnionitis. The baby too is doing well in the NICU with minimal support. 

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