Blood Transfusion?

Dr. Tom took over all the deliveries and prenatals while I was away. He delivered two babies and referred a woman with twins (one that died in utero) to Wau for a cesarean in the two weeks I was gone. I'm sure he saw a lot of prenatals as well.

One of those prenatal girls came in sick (initially testing negative for malaria) and was treated with a course of antibiotics. At that time, her hemoglobin was an 8. Anemic. In pregnancy, it shouldn't drop below a 12 or else even a slight amount of blood loss can cause her to go into shock. And a moderate hemorrhage, might kill her.

When I got back from my trip, I was told she had returned, still sick, and tested positive for malaria. She was treated, however in the week it went undiagnosed, her hemaglobin dropped to a 4.4!

Not good at all.

She needed a blood transfusion but we don't have the equipment for that. Dr. Tom looked up direct transfusions in his medical books and brain stormed the idea with Dennis and Caleb. They were all game to get her the blood she needed.

They started testing all her relatives for crossmatches and found two donors that would work. This was only made possible by George tirelessly working to screen them all in the lab. It was a lot of work.

The question was, could we actually pull it off before the blood coagulated? Nobody really knew. They tried a number of ways, using a variety of instruments and techniques, but none of them were working.

It was harvesting the blood that was the most difficult. 

Hours later we finally got a bit transfused without it coagulating -- but only about 30 ml. That's not enough to bring her around. It helped of course but she's not out of the woods. Our only option was to send her to Wau and hope that she goes.

The good news in all of this is we fine tuned our techniques and now know what works and what doesn't. And even though 30 ml is not anywhere near enough for an adult woman, it's plenty for a young child who might be suffering from anemia.

This gives us options we didn't have before. I'm excited.

Let's start praying for blood bank and transfusion section in this clinic! Anyone in?

Also pray with me that this girl is able to stay healthy and deliver well. Thanks.

~ A surprise ending ~

Mai-Mai came into the clinic moving slowly. She had a strange, wild look in her eyes and she keep repeating over and over again in a low whisper, "My baby is coming! My baby is coming! .... My baby is coming!" Together we walked to the bed where she started pushing immediately. Within minutes, a little patch of dark black hair poked through. A push or two more and little Jonred joined us on this side of the uterus. It was a slow, sweet birth .... truly beautiful. Then... we all sat back and enjoyed this little crying, slimy boy a bit while we waited for the placenta. When it came time for the placenta, she pushed once, twice... there were no signs of placental separation; no bleeding. There was just a bit of cord lengthening. So I waited. Then as I looked down to see her push for the third time I was startled to find myself COVERED in her blood! Her placenta hung most of the way out but her blood was everywhere... mainly all over me! The best part was the reaction of everyone in the room! My assist, supervisor and the father of the child all recoiled in unison! Together they all made the same sound of disgusted 'uuugggggggghhhhh!!!!' I was covered from neck to thigh in almost 100 cc of blood! Then we laughed and I made a B-line for the shower! I should have taken a picture... :- )