Dr. Shin Seonhan: The Doctor Who Sees The Future [EN]: Chapter 159

#159 Happy Birthday (18)

‘Wait a minute… this bleeding is unusual.’

Even I, as an intern, could tell why the professor was tilting his head.

The bleeding was much heavier than usual.

I assisted by suctioning as he opened the abdomen and approached the uterus.

As expected, the professor quietly muttered to himself, sounding troubled.

“Using heparin makes a difference, doesn’t it…”

He was right.

It was distinctly visible that blood was flowing easily even from places where there hadn’t been any bleeding during previous cesarean sections.

From the surgeon’s perspective, his lips must have been parched.

“Bovie.”

Zzzzzz—

He tried to stop the bleeding with a bovie [electrosurgical unit used for cauterization], but it seemed the more he cauterized, the more the bleeding increased.

Soon, I could sense the professor’s anxiety in his words.

“There’s quite a bit of bleeding. We might need a transfusion.”

“We have it ready.”

In response to the obstetrician’s words, the anesthesiologist leaned his head over the drape and replied.

As he said, blood products such as red blood cells (RBC) and platelets (PLT) were already hanging on the IV pole.

“I’m worried about closing later… Let’s get the baby out first.”

Obstetrician Professor Jo Jae-yong’s hands moved busily as the patient’s uterus came into view.

The uterus is basically an organ made of muscle, with a sufficient blood supply.

Therefore, it is naturally sensitive to bleeding tendencies.

Pressing the bleeding area with gauze while quickly approaching the inside, the professor began to cut the uterus.

“Jeong-nam, hold here, and the intern, suction diligently here!”

“Yes!”

“Yes!”

I coordinated with Dr. Yoo Jeong-nam and moved my hands.

Meanwhile, the professor used a scalpel (mes) and scissors to cut the uterine wall.

Then, with skillful movements, he reached into the area where the baby was.

After a moment.

The baby began to emerge headfirst from the uterus.

“……!”

The baby’s small face is visible.

How difficult must it have been due to the lack of oxygen?

Just imagining having to breathe in a place with extremely low oxygen levels gives me a slight understanding of the difficulties the baby faced.

And this child endured that hardship for 32 weeks.

Of course, due to the low oxygen levels, the baby only grew to be in the bottom 10%…

I felt truly amazed that this child had endured that process.

“Baby is out!”

With the obstetrician’s words, the baby saw the light of the world and came completely out of the uterus.

‘Small….’

That was my first impression upon seeing the baby.

I had been in several cesarean section surgeries, but this was the smallest baby I had ever seen.

Does it weigh 1.5kg? [approximately 3.3 pounds]

No, it seems smaller than that.

Of course, I had somewhat expected it, but seeing it with my own eyes made me suddenly worried.

I wondered if the heart and lungs inside that palm-sized body would be able to function properly….

The life of Jeong No-eul B (Baby), who came out of the uterus after 32 weeks, now depended on the team.

Beep—

The pediatrics team pressed the timer.

For a premature baby, the first minute after birth is the golden time.

Because it is the most crucial time that determines the baby’s life or death.

Thwack—

As soon as the obstetrician took the baby out, he cut the umbilical cord.

Then, he immediately placed the baby on the warming bed (a bed to maintain the baby’s body temperature) that was being prepared next to him.

Soon, three members of the pediatrics team surrounded the baby placed on the warming bed and began to move busily.

Electrocardiogram electrodes were attached to the chest, and an oxygen saturation monitor was attached to the right hand.

Also, a hat was placed on the baby to maintain body temperature.

1 second, 1 second….

All the processes take place in an instant while the timer is running.

While assisting the obstetrician who was stopping the bleeding in the surgical field, I kept one ear open.

‘In the future I saw before, the baby ended up going to heaven… Please, the baby has to be okay.’

Not only me, but everyone was anxiously waiting for the pediatrics team’s response.

But, something is strange.

The baby’s cry cannot be heard.

The absence of crying means that spontaneous breathing is very weak.

“……”

Tension fills the operating room.

The pediatrics team’s hands were moving even faster.

They raise the baby’s body temperature and secure the airway by placing a small blanket under the baby’s head.

They also remove foreign substances (secretion) from the mouth.

But still, the baby’s cry is not heard.

“Initial HR (initial heart rate) is 84!”

The heart rate is one of the most important indicators for determining a baby’s life or death.

Jeong No-eul B’s heart rate is 84 beats per minute.

It would be a normal number for an adult, but it is a significantly low number for a newborn baby.

It should be at least over 100 to be considered close to normal.

The anxiety of everyone in the cardiothoracic surgery, cardiology, and operating room nursing teams, who are watching this entire process, intensifies every second.

I could tell from their eyes that everyone in the operating room was shouting inwardly.

“Mask!”

The pediatrician grabs the mask without hesitation.

They are trying to secure the baby’s airway through positive pressure ventilation.

Meanwhile, time is running out.

“30 seconds have passed!”

A member of the pediatrics team who was timing shouts.

Poosh, poosh—

Air is being injected into the baby, who weighs less than 1.5kg, through a small mask the size of two fingers.

Ticking, ticking—

Before long, the time recorded on the timer exceeds 40 seconds.

However, the baby’s heart rate observed on the monitor still does not exceed 100 beats per minute.

‘Baby, please.’

I shouted desperately in my heart.

One second feels like one minute.

How much more time had passed?

When everyone watching the baby’s lips were drying up.

—Euh… Waaah….

A small cry came from the baby’s mouth.

“……!!”

Relief, joy.

Various emotions spread.

How can I express this feeling?

It feels like I went back and forth between hell and heaven in a short period of time.

As the baby began to breathe, the doctors and nurses who had been holding their breath finally exhaled.

The baby finally started crying when the time on the timer exceeded 1 minute and 10 seconds.

—Waaah, Waaah!

The baby’s cry gets louder and louder.

That such a small child can cry like that….

It is so amazing that I can’t believe it even while experiencing it on the spot.

I realized for the first time that even a 32-week premature baby who had grown in the bottom 10% could cry so loudly.

So the feeling of joy that I feel comes to me even greater.

‘The fact that the baby cried means….’

Now, I could tell that the baby had avoided an extreme emergency, even though the mother’s safety could not be assured.

At least, a crying baby is unlikely to receive chest compressions (CPR).

At the same time, the baby’s heart rate also rises to 120 beats per minute.

“Phew, that’s a relief. Doesn’t it look like the baby is okay?”

Professor Heo Jun-im was the first to speak.

Everyone in the operating room must be relieved.

The operating room, which had been filled with heavy silence for a while, began to regain its vitality.

Soon, the pediatrician said to the pediatrics team member.

“The APGAR score will be 8 points. Record it as 3 points at the 1-minute mark.”

8 points!

Better than expected.

I couldn’t be happier to hear that from the pediatrics department.

The APGAR score is a system for quickly assessing the health of a newborn.

—Appearance.

—Pulse.

—Grimace.

—Activity.

—Respiration.

Each of the five items is given a maximum of 2 points, and the scores are added up.

From 0 to 10 points.

A total of 7 points or more is normal, and 3 points or less is critical.

If it’s 8 points like now, it’s safe… no, it means it’s healthy enough.

APGAR score of 8 points performed 5 minutes after birth, oxygen saturation (pre-ductal spO2) is 85%.

In other words, the baby’s condition is better than expected!

The pediatrician, who had been watching the baby a little longer in the incubator in the delivery room, shouted.

“That’s a relief. I think the baby will be okay, I’ll transfer Jeong No-eul B to the NICU (Neonatal Intensive Care Unit) right away!”

Whirr—

Opening the operating room door, the pediatrics team put the baby in an incubator and left immediately.

Of course, I can’t be 100 percent relieved yet….

This is Yeonguk University Hospital.

They have probably had countless experiences dealing with premature babies of that level in the neonatal intensive care unit.

So the child will grow up well.

I believe that now.

‘Okay, I’m relieved about the baby for now….’

From now on, it’s the second round.

It is the mother’s lonely war.

After the pediatrics staff left, the work of removing the mother’s placenta was in progress in the operating room, where one side had become empty.

Just remove the placenta as usual and suture it.

“……”

But.

The obstetrician’s eyes were shaking.

This was because blood was continuing to fill not only the outside of the uterus but also the inside of the uterus.

In other words, blood was flowing from everywhere he touched.