----- Original Message -----
Sent: Saturday, July 12, 2003 1:00
AM
Subject: Re: [ozmidwifery] whats
happening ?
Hi Lynne: yes it is weird how transfers can
cluster sometimes. Exhausting. Regarding the Mg SO4 and >BP, one young
woman I worked with in Seattle developed high BP after we made the hospital
transfer(we transferred for maternal exhaustion, she had been labouring hard
for 2 days and was still 3cm, BP had been stable at home, no other sx except
that she had had heartburn/reflux throughout the pregnancy and i have wondered
since if this masked any epigastric pain) anyway BP went from 120/70 at home
to 138/88 on arrival at hospital, to 144/90 to finally 160/100, this was after
the epidural but while we were awaiting the stat liver function tests which
the ob ordered "just in case" actually apologising for ordering them as we all
thought the elevated BP wasdue to the stress of the transfer.She had HELLP
syndrome, so Mg SO4 and much careful monitoring, she went to complete in 2hrs
and pushed her baby out in between vomitting from the Mg SO4. There was thick
to mod mec liquor too, baby was 8lb and vigorous at birth. She stayed in
hospital 3 days on meds until her bloods were normal and BP stable, baby very
jaundiced really should have had phototherapy but parents declined and went
home. Mum also somewhat jaundiced (I guess the hemolysis). Baby was under
paediatric care, lost >10% in first week, milk took a good 7 days to really
come in once it did baby made a slow but steady weight gain. WE, the midwives
were somewhat anxious, but paed was ok with it doing homevisits and sun baths
for baby (trust me the UV index in Seattle is not to be worried about). Long
story, sorry. So yes the milk did come in just later.
marilyn
----- Original Message -----
Sent: Thursday, July 10, 2003 2:14
PM
Subject: Re: [ozmidwifery] whats
happening ?
Hi Jan
Must be something in the water - I had 3
t/f to hosp as well in the past 2 months. One - a primigravida - C/B
after BP shot through the roof antenatally and SROM at 37 weeks. She did
labour, but for whatever reason, her body did not open, and her BP sneaking
up higher and higher despite Mg So4 and hydrallazine. Home now but lactation
did not establish and she has tried everything. Is anyone aware of MgSo4 or
hydrallazine having an impact on lactation?
Another had the most amazing labour - had been
labouring for quite some time before she called (as she and partner had been
happy working together). First baby. After some time I asked if I could
examine her - something wasn't right - she had the most awful back pain and
the babe was not OP - the head VERY deep in the pelvis and had been for some
weeks prior to birth. Head was +2 and covered with lower segment. Looking
for cervix and finally located it very high and anterior behind the right
obturator foramen. Pinhole in size and the lower segment/cervix paper thin.
No wonder she had this dreadful backache. I began to massage the tine hole
in her cervix very gently - within 5 mins had opened to 3-4. Another 2 hrs
later, still awful backache (imagine the stretch on her posterior
ligaments), and still the same. Some more gentle massage and the cervix
opened to 5-6. Into bath, but backache absolutely unbearable after another
hour. Penney asked me to massage again, but my short little fingers could
only coax it to 8 where it stayed for the next hour. She decided to go to
hosp for some pain relief (!), and when we arrived I organised an epidural
for her. Asked to check her again before the anaesthetist arrived, because
it might change what she wanted to do - anterior lip, backache gone and she
pushed out her baby after I phoned the anaesthetisit to say we wouldn't be
requiring him after all. All of us crying - one exhausted but oh so
triumphant woman.
Third primigravida, who laboured beautifully at
home and the baby just did not come past caput on view despite everything we
tried. So decided to go to hosp, where she had a reseonably difficult
ventouse - no analgesia (her choice) - she just wanted to have the baby.
Hospital staff were wonderful in each case - women and their partners
treated with respect and each of the women has come away feeling good about
the transfer.
Whew! Sorry about the length of this posting
but needed to talk! Thanks for the opening, Jan.
From another very tired and continually learing
midwife - Lynne :-)
----- Original Message -----
Sent: Thursday, July 10, 2003 11:14
PM
Subject: [ozmidwifery] whats
happening ?
bad run?
unbelievable 5 births this month3 c/s trans
from homebirth 1 normal del priv hosp 1 normal del home what is
happening bewildered tired and yuk jan
