Muder??? Dec. 2

     Last week we had two ruptured uteri with dead babies.  Both had been given large doses of oxytocin (medicine to make uterus contract) IM by someone in a village clinic before arriving here.  The first one was her 9th pregnancy so it would have been easy to have missed the diagnosis but the uterus just didn’t feel right.  When we opened her abdomen there was lots of blood and baby and placenta through the ruptured uterus in the abdomen.  The bladder also had a large tear in it way down by the cervix.  We repaired the bladder hopefully not getting the ureter.  The urine cleared and she is doing ok now.  The second one was similar but no bladder involvement but the uterus was split open vertically.  We tied the tubes of the first one but the husband would not let us do the second one as it was only her 3rd pregnancy with one living child.  
     Apparrently some of the “midwives” have been told by some Chadian doctors that it is ok to give IM oxytocin.  Danae was recently in a conference about OB care before she went on annual leave and there was discussion about this practice.  She tried to point out the dangers of this practice but apparrently they get away with it part of the time but here were two dead babies and could have been dead mothers because of this practice.  We might call this murder or manslaughter if we did this at home.  What does it take to get better medical practice going?  How many die that we never hear about that ruptured and bled out and died before arriving here?  We don’t know.  Meaningful statistics are nonexistent here as they don’t put down true numbers at all and some of the people doing them are not able to do basic math.  
     I have had at least 14 C-sections and 4 vacuum extractions since Danae left on annual leave Oct 25.  We also have had 3 molar pregnancies and a vaginal hysterectomy and abdominal  hysterectomy during that time and have a very large tumor prolapsed uterus for tomorrow and a mass about 7 months size that maybe is a large ovarian cyst.  
     Life is interesting for OB-Gyn.  Continue to pray for our patients.
Love,  Rollin and Dolores
Our emails: drbland@sbcglobal.net and dfbland@gmail.com