Case Studies

A story in an Obstetrician’s voice

Image © : Save the Children

“I can still remember the face of that pregnant girl came in a grave condition at Dhaka Medical College Hospital back in 1994 when I was an intern doctor there”, said Dr. Sitara Rahman, a practicing Gynecologist and Obstetrician. Mrs. Aklima Begum, a young lady of 21 years old came to Dhaka Medical College Hospital emergency at 37 weeks of her pregnancy with severe lower abdominal pain. Her physical examination revealed that the patient was anemic, her cervix was not dilated that means she was not ready for normal delivery and fetal heart sound was not audible.

As the pain was aggravating and patient’s condition was deteriorating with fall of blood pressure. So doctors suspected that it could turn as a case of ruptured uterus and advised for caesarean section. Patient’s husband said, “A wrist watch and very less money, that’s all I have. Please start the necessary treatment.”

But their main guardian was Aklima’s mother-in-law, who was not ready to give consent for C-section any way. She was counseled thoroughly about the possible risks and consequences, but her decision was not changed. Meanwhile her condition worsened and features of shock was found. Seeing this her mother-in-law gave consent and patient was rushed to operation theatre. But when her abdomen was opened, doctors found that her uterus was ruptured and the baby was already dead. Then after expulsion of the baby and products of conception, the uterus was repaired. 2 bags blood was transfused.

Later she went home and came back for stitch off.  After removing the stitches doctor found that the uterus was not healed up at all probably due to anemia. Again secondary stitch was given and blood transfusion was done. Eventually she was healed up, but her uterus was affected so badly that she was forbidden to conceive for at least next 5 years.

(Disclaimer: The subject's actual name and pictures have not been used for privacy concern)

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