Pre-eclampsia Update:

My precious pre-eclamptic patient, Pour, came in today for a check-up. I’m always happy to see her and greeted her with a big smile. She smiled back and sat down slowly. My translator had just stepped out, so I asked her to lie down, so I could check her baby.

She shook her head sadly and said there was no more baby to check. My Dinka’s limited, but I somehow understood all her words. I instantly wanted to cry, (but culturally, crying is not an option), so I blinked back tears and waited for my translator to return.

My heart sank as she explained she’d delivered her baby 4 days before. She only had two hours of very intense contractions and her baby was born. He breathed twice and then died. She also explained that he was term but thin and had ‘burns’ all over his body.

I’ve seen one other macerated baby (a baby who dies in utero and starts to decompose) before and as the skin starts to peel, it does look like the child has been burned. It doesn’t make sense that a macerated baby would breathe, but I didn’t tell her that. If he was macerated, he’d probably died a day or so before the birth.

Her blood pressure was still high and her body ached. I wanted to wrap my arms around her and bawl; but again, such antics are not socially acceptable. Instead, I taught her more about pre-eclampsia and why her baby probably died. I also prayed for her to have peace about her child and to know Jesus’ comfort and joy in this hard time.

Should I have induced her last week? She wasn’t term (I’d have to check, but I think she was only 34 weeks last week), and her fundal height was only 22 cm.

I don’t know.

She’ll keep coming back each week for follow-up checks. Pray for her blood pressure to stabilize and her body to recover quickly. Thanks.

Hypertensive!

I have a girl coming for prenatals who has a fundal height of 21 cm at 30 weeks due to pregnancy induced hypertension (or possibly pre-eclampsia). Her belly has not grown since October when her blood pressure skyrocketed (as if overnight) to 185/130. (Previous it was in the 110/80 range.) Early December, we started her on BP meds but I guess she didn’t understand she had to stay on them permanently for them to be effective and didn’t return until yesterday.

Her fundal height and blood pressure combined, had me ready to refer her to Wau on the spot. But conferring with Dr. Tom, he pointed out the obvious. What could they do for her there that we cannot?

My brain stuttered as I realized how right he was. If she went to Wau, she would pay for all her meds, incur a huge bill and still deliver a small baby. Yes, she is at risk for convulsions and stroke, but we are aware of that. What’s more, God is aware of that! 

Quick! Somebody stop me from worrying like this all the time! S*i*g*h.

Pray for her please. She promises to come for weekly check-ups and to take her meds, and I promise to keep you posted.

Lyn-Lyn's Eleven!

This little guy is a little miracle.... His mother was one of the women I did a few prenatals on. She was very nervous about her pregnancy. She is 35 years old and hadn't had a child for 11 years. She was afraid that perhaps she wouldn't remember how. :- )

I really liked her and when I saw her come into the clinic in active labor while I was on shift, we were both thrilled. Normally, I would have taken her as a continuity (which is when I am her only midwife) but I wasn't expected to be delivering babies any time soon. So when God put us together anyway, I was very excited.

There was only one problem. She came in at 6 cm but with VERY HIGH BLOOD PRESSURE. It was 140/100. If we couldn't get it to come down, we would have to send her to the hospital to give birth.

None of the women that come to our clinic want to go the hospital. When we transport them for complications, they are never happy to go. The hospital will not allow anyone to support them while they labor. They go through it without any loved ones. The staff there is over-worked and the rooms are stark and sad. Plus, it costs much, much more.

Lyn-Lyn was not excited when we told her she might be transported. I went to talk with her about it and we prayed. We prayed A LOT!!! Then we left it up to God. Long story really short... her BP came down little by little and little baby Joncel Kieven was born a few hours later.

The best part is she gave birth on her first son's birthday! How is that for timing? She has had two boy exactly 11 years apart!