Last Duty Syndrome

31 march 2006

it's my last 24hour duty in the department of obstetrics and gynecology. i've been benign for the entire 2-month rotation except for one occasion. but this day shaped into one toxic day. the patient we admitted was pregnant, but preterm (31 weeks by LMP), in preterm labor, and a gravidocardiac. patient was known to have Lutembacher Syndrome (Mitral Stenosis and Atrial Septal Defect), so we were quite careful. UTZ was done, results showed the fetus to be 34 weeks old. but then she begins to congest, starts to have difficulty breathing, and physical exam showed rales mid to lower lung fields. hmm, patient continues to go into labor and we weren't able to control the contractions. so a decision was made to deliver the baby, but we had to monitor the patient's CVP to ascertain how much fluids is allowed to be given. during the CVP line creation, there were lots of difficulty. it was awful seeing the patient in pain, and crying. i thought i'm already cold and unemotional but this time i really felt bad for the patient. she never complained, she just asked 'what are you doing to me?' after it was taking quite a while to create the line, and she was already crying. it was awful. but finally the line was created. after a while, she delivered her baby. it was 35 weeks by ballards score. patient was then placed in the icu, but it was a good thing that there were no complications afterwards. i slept at 6 a.m. that day, and woke up 7:30 a.m. -- Last Duty Syndrome! my groupmate told me that i had to save the best for last. the following day, the baby was already able to feed. very good news indeed.