Pic2: Kielland's forcep
Yatta~!! I conducted my first delivery!It was easy becoz the patient was G3P2( meaning this is her 3rd pregnancy and have given birth to 2 children).It was quite fast, probably less than 4 minutes.At first, Staff Nurse A offered me to conduct the delivery not once, not twice but three times.Ditambah pulak dgn member comel aku yg sorang lagi tu yang bernama Burg, asik je menyiku-nyiku aku, 'Bil, pergi ar! Buat je, kau mesti boleh punye' . Hmm so, kite ni pun ape lagi laa kan.Terus amik sterile glove size 7, pakai and pergi conduct the delivery under the supervision of a nurse.The baby had a condition called 'Cord round neck'.Terkejut gak la memula.Alhamdulillah everthing went well.Perlu diingat disini iaitu delivery of a baby is not as easy as what you might think it is.It is an art!Did you know that there are as much as 8 steps during the Second stage of labour ( belum lcakap pasal the first and the third stage of labour).A lot of things to be assessed before, during and after the delivery. Terpaksala tunjuk macho sikit tadi sebab ada beberapa student nursing kat dalam labor suite tadi.Malu la kalau tak betul kan? =P
I also managed to witness a Twin delivery ( At last, doaku dimakbulkan yer) .This was a dizygotic, dichorionic diamniotic twin.Memang respek la mak dia.She really wants to deliver vaginally and not thru Cesaerean section.Twin 1 was in cephalic presentation ( kepala kat bawah), HOWEVER the twin 2 was breeched ( kaki keluar dahulu).It was footling breech to be exact ( There are a few types of breech presentation) .Doktor pakar was there.Again, delivery of a baby with footling breech presentation requires different skills and manouvre.The delivery of twin 1 was quite easy.The baby came out quite easy once the membrane ruptured.The baby came out at 2.25 pm.
The delivery of the second twin was a bit tricky due to the presentation part.The Obstetrician had to do an Ultrasound scan and later did a manouvre called External cephalic version, in order to maintain the baby's lie (twin 2's lie was an unstable lie, kejap dia pegi longitudinal lie, kejap dia pusing jadi transverse lie).Manouvre ni bertujuan untuk memusingkan baby dari luar dengan menggunakan tangan ,so that the fetus will have a suitable position for delivery.According to the book, the delivery of the second twin must be done within 30 minutes after the delivery of the first twin.Therefore, patient was given IV Pitocin to stimulate uterine contraction.After about 10 minutes, the Obstetrician decided to artificially rupture the second twin's amniotic membrane.There was a sudden gush of amniotic fluid.Tak ubah mcm waterfall.To cut the story short, Twin 2 was delivered by using a few manouvres.So dapat la aku tengok camne rupe manouvre Mauriceau-Smellie-Veit manouvre ( manouvre yg sampai skrg aku tak dpt nk sebut namanye).Stylo betul doktor tersebut.Kagum aku dengan dia.According to our professor,there are a lot of risk in breech delivery.You have to be fast and sure in what you are doing.Every second counts.Twin 2 was deliver at 2.43pm.The baby was born flat.She did not cry.A pediatrician was already on standby and she resuscitate the baby.Akhirnya, kedua-dua baby tu selamat.Cuba teka dapat baby ape?Twin 1 was a baby boy while twin 2 was a baby girl!
Today was a busy day.The PAC(patient admission counter) was packed with patients.Labor suites pun agak penuh.Back to back.Kadang-kadang sampai tak sempat nk prepare the instrument pun.I had the chance to do episiotomy suturing on 2 patients and 1 placenta cord traction.
Later in the afternoon, we had a teaching session with Dr S, a senior O&G specialist.We learn about Intrumental delivery using Ventouse( a.k.a vaccum) and Forceps.
Ok la bye.Nak lelap jap.I have on-call tonight.