Monday, 3 October 2011

Pictures of a caesarrean (warning, gory!)

28/9/11 This blog is a work in progress as it will take some time to upload all the pictures I want on it using the internet here but I'm going to start! Eventually it is going to be a step by step picture blog of a caesarrean I saw today - so it is not for the faint hearted! Faces have ridculous shapes on them to shield identities crimewatch style! The patient was having an emergency caesarrean due to Eclampsia (a condition where the patients blood pressure is very high and leads to fits. This condition is very serious for both the mother and the baby).

The patient is anaesthised using ketamine (even though before the operation the doctor said ketamine would not be used because ketamine itself can cause high blood pressure and therefore worsen the patient's condition).

The caesarrean is in progress. Here caesarrean's are done by a midline (also known as classical) incision. This type of incision is not favoured in the UK as it does not heal as well and it more likely to rupture in future pregnancies.

Because the patient has eclampsia her blood pressue is checked very regulary throughout the operation. Fortunately it remains stable although still a little high.

The patient is given dextrose throughout the operation to replace some of the fluid that is being lost during the operation. With no diathermy available here (diathermy stops bleeding from small vessels) blood loss tends to be greater than in the UK. However they also have a severe shortage of blood, so unless bleeding is vast, patients are only given IV fluids to replenish fluid which is lost. Sometimes even when bleeding is vast, there is no blood available for the patient... Fortunately this patient did not bleed too much.

The doctors reach in to try and pull the baby out!

The baby is delivered! He initially scored low on the Apgar scale and needed resuscitation (no pictures of this - a) it didn't feel right as it was uncertain initially if he would pull through and B) I was assisting a bit with the resus. He was doing a bit better after resuscitation and is now in the baby room for extra care).

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