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Placental abruption, from the nurse's point of view

Posted Jan 24 2011 9:17am
It was change of shift, and I was just starting out my shift on L&D. *Annie and her husband *Frank (*names changed*) had also just arrived on L&D. Annie had noticed some vaginal bleeding, and she and her husband were concerned about this, so they decided to come in to be evaluated.

Annie had a known history of a partial, but stable, placental abruption. I walk in the room to find two nurses valiantly trying to establish an IV site and maintain fetal heart tones.

**thump...thump...thump**

The fetal heart monitor is kicking out a too slow rate ~ about 80-90 beats per minute. Oxygen is on and one of the nurses turns Annie on to her side.

**thump.........thump..............thump**

Even slower.

I jump in and deftly insert an 18 g IV site, pulling various tubes of blood off of the line, then hook up IV fluids.

**thump..................thump............................thump**

Slower and slower.

We race Annie back to the OR. Her poor husband Frank, bless him, understood the implications of what was happening.

Everyone is rushing around in the OR, working to get Annie transferred to the OR table, catheter placed, instruments at the ready. Annie looks around, about ready to burst into tears. I'm on the phone with the NICU, telling them we have a STAT c/s for an abruption, hearts are down.

I walk over to Annie, get down close to her ear, gently touch her arm and hand, and whisper to her
"My name is ____. I know it's very scary right now, but we're doing many different things at one time to help get your baby out. You're going to feel the catheter go into your bladder in just a second here - it's going to burn and hurt for a minute. Cold gel on your belly as we listen to your baby's heartbeat - listen to that! It's up again at 120 beats per minute. That's very good!"

Annie nods her head, tears welling in her eyes. "His name is Matthew."

"The baby?" I ask her.

"Yes, his name is Matthew."

"Annie, we're going to work very quickly now to get Matthew out, and we will take very good care of him and you. You're going to go to sleep in a just a few seconds here, but I will be with you and Matthew the whole time."

"Save my baby," she says, as we tightly grip each others hands.

Cold antiseptic solution is splashed on her belly as Annie is quickly put under general anesthesia.

**incision!**

**membranes ruptured - bloody fluid!**

**baby!**

An immediate lusty cry is heard as baby Matthew is born.

Audible sighs of relief can be heard throughout the room as Matthew is dried off and assessed by the NICU team.

Frank, now a proud new papa, is escorted into the OR to greet his new son.

**smiles**

A very positive outcome for a situation that could have been much more dire.

Times like these make me feel very honored to be present at the amazing miracle of birth.

Happy birthday Matthew!
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