Today I was in the maternity ward again. I and another student also named Megan arrived at the operating room and changed into our clean scrubs. The staff informed us that today would be a busy day as they had 4 C-sections on the agenda. After we got changed we talked with the surgeon for about a half hour about random things. He was very nice and seemed very fond of us. Not long after the first mother was ready for surgery, so we jumped up and proceeded into the operating room. Once we were in the anesthesiologist prepared the drugs needed for the surgery. Here when they do a C-section they put the mother under full anesthesia, whereas back in the U.S. they don't do this. The surgeon scrubbed in and got prepared and the surgical techs prepared the tools. The surgery began when the surgeon made an incision horizontally in the pelvic region. He proceeded by cutting into the tissue layers until he finally reached the uterus. He then made an incision in the uterus, reached in and pulled the baby out. Once the baby was out, they cut and umbilical cord and took the baby to another room. The surgeon then placed the uterus outside the body cleaned it out, sutured it back up and put it back in place. He then made sure all the blood and everything was clean inside before he began suturing the tissue back together. Once he finished the suturing he applied pressure to the abdomen and finished cleaning out the uterus. The mom was cleaned up and so was the surgery area.
During the surgery I was able to watch the anesthesiologist closer than I ever had before. She was very informative and broke things down. She gave me and the other Megan nicknames since we have the same name; I am Maggie S and the other Megan is Maggie T. The S stands for short and the T stands for tall. At the beginning of the surgery she allowed me to inject the anesthesia to the patient and then we gave her a muscle relaxant. Once she was asleep we placed a breathing tube down her throat because once someone is under, their lungs wont function for themselves so the machine is hooked up to keep the lungs working and the patient alive. We also kept a constant flow of saline solution through an IV to help replenish the blood loss during the procedure. They also had a vital machine hooked up that constantly keep readings on the mothers blood pressure, oxygen concentration and pulse. Once the surgery was complete the anesthesiologist had to reverse the effects of the drugs we gave her to knock her out. Once the drugs were administered it only took a few minutes for her to come out of it. The anesthesiologist had to keep an eye on her until she knew the mother was breathing on her own and then she removed the breathing tube. After the surgery the mother was placed out in the hall because they don't have recovery rooms for the patients.
We took a short break and then proceeded with another C-section. The procedure went much like the last, but when it came time to get the baby out the surgeon was struggling to get in through the small hole. Once the baby was safely removed, they again pulled the uterus out to clean it. But this time when they went to put it back it, it didn't want to budge so they had to make the incision just a little bit bigger and were able to put the uterus back. It is amazing how huge a uterus can stretch compared to the size of it normally. We were talking to one of the surgical techs and she was explaining to us that C-section mostly have to be done because there is a complication with the pregnancy. In the first case today I am not sure why she had to have the procedure done, but the second on had to have it done because her baby was too big. She said the baby weighed over 4 kg, which is about a 9 pound baby. I think that they aren't able to handle a mother giving birth to a larger baby in case complications could arise while giving birth. Once this procedure was over it was time for us to leave for lunch so we didn't see the other 2 C-sections.
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