Bismillah
Assalamualaikum
An accident happened, it was grave. Between two cars and both cars were crushed, inside one car there was a pregnant woman. At her early 20, very young and suspected to be a primigravida she was about 36 weeks near term and was unconscious.
When she opened her eyes she can only see lights pass over her as she was floating but everything were hazy because her Glasgow comma score is below normal level. She heard people shout "make way and step aside, we need an orthopedic surgeon and an obstetrician".
Little does she knows, she just had a major accident and the provisional diagnosis was open open book fracture pelvis with pregnancy. As any other pelvic fracture the blood loss is severe. She was definitely in shock!. Thus she was stabilized at the emergency room by blood and volume expander.
Then came the two major player in this case, an orthopedic surgeon and an obstetrician. The first examined the pelvis clinically and call for a CT scan for better analyze and the latter checked the fetal viability by ultrasonic guidance.
But sadly, the fetus had no cardiac pulse and could not be save due to the trauma and the shock that occurred earlier. After that, the obstetric wanted to do a hysterotomy to remove the fetus because to him dead fetus will releases substance that induce coagulation and can cause Disseminated Intravascular Coagulation.
The orthopedic surgeon doesn't agree with his partner's opinion and they medically quarreled. After few calls and consultation from their seniors, the orthopedic surgeon proved a very crucial point. Never deliver the baby in pelvic fracture because the gravid uterus acts as an active packing that prevents the horrible bleeding in this kind of fracture and literally saves the mother. As for the DIC we should just monitor her Fibrinogen level and give her FFP or Frozen plasma.
They both have glassy eyes after realizing that the baby had saved his mother's life.
One of them add, "the baby saves his mother!!
doesn't that very noble and touching?". Then the other one said
"indeed i'm sure that the baby is very proud of himself and says,
mummy sorry i can never see you, but i save you".
Thank you.
