On Fridays we have our gynaecology outpatient clinics. They are usually very busy, with 60-90 patients most days. And on the 29th I was just finishing up (an hour late), very eager to get off for some important weekend plans (about which more in the next blog). But on my way out the door I was stopped, 'Doktari, we have this very short woman who has come in in labour and the baby is transverse.' Well, 'short' was definately correct. I don't know exactly what was wrong, she didn't look achondroplastic, but she clearly had severe bony deformities - less than 4 feet tall, contractures of knees, hips, pelvis, elbows and wrist, severe kyphosis, scoliosis and lordosis (i.e. a very twisted and fused spine).
The anaesetists tried to site a spinal with no success and eventually did a general anaesthetic and secured an airway with a fibre-optic ET tube (all this is very fancy stuff that I'm fairly amazed we even had). Then my challenge was getting into the abdomen with her hips flexed at 90 degrees, and trying to figure out where important structures like the ureters were running (they were pushed way out of their normal position). But praise God we had a healthy mum and a healthy baby.
Mother and baby in the nursery.
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