Fifth Vital [EN]: Chapter 260

Five Vital Signs – Episode 260 (260/502)

260. A Mass of Blood Vessels

While the mother’s family anxiously waited in the waiting room, her pain intensified as she was being taken to the operating room.

“Ugh! My stomach hurts.”

Eui-jin, hurrying to move the bed, quickly palpated [examined by touch] the mother’s abdomen.

“……!”

Eui-jin’s expression darkened. She briefly stopped the bed just outside the delivery room.

“Just a moment. Let me check her cervical dilation.”

While Eui-jin inserted her fingers to palpate the cervix, Tae-kyung examined the mother’s abdomen.

‘The smell is fortunately at stage 2… but wow! That’s huge.’

Though he didn’t show it, Tae-kyung was quite surprised. The myoma [uterine fibroid, a benign tumor] was enormous.

Even under normal circumstances, bleeding is the most critical concern during childbirth or cesarean sections.

The uterus and placenta in late pregnancy are essentially masses of blood vessels, so the potential for hemorrhage is significant.

Even if everything else is normal, excessive bleeding alone can be life-threatening.

But with a myoma situated right there on the mother’s right abdomen, the situation was truly frightening.

“The cervix is fully dilated,” Eui-jin announced, interrupting Tae-kyung’s thoughts.

“Let’s get her in!”

“Yes, Doctor.”

At Eui-jin’s command, the nurses wheeled the bed into the delivery room.

Just moments ago, after assessing the mother’s condition, it was clear she would have given birth in the ambulance if they had tried to transfer her to another hospital.

Eui-jin once again felt relieved by her decision and focused her attention on the mother.

“Ah! Aagh!”

They carefully moved the still-suffering mother onto the delivery bed and positioned each leg in the stirrups.

“Ah… aagh!”

The mother screamed in response to the unrelenting pain.

The pain experienced during childbirth is more intense than many can imagine.

Some mothers who have successfully delivered their first child say things like this:

‘If I had known it would be this painful, I never would have gotten pregnant. I almost died. I told my husband not to even think about a second child.’

They are reluctant to repeat the arduous childbirth process. Moreover, childcare presents its own set of challenges.

However, as time passes, they experience immeasurable joy and love from their child and begin contemplating a second child.

Of course, not all mothers feel this way, but a child holds a special and profound significance for parents, especially the mother, in a way that defies explanation.

That’s why this mother was enduring this agonizing process.

“Aaaagh!”

“Mother?”

Eui-jin spoke as the mother screamed again.

“It must be very difficult, but I’ll help you push in sync with me. Push when I count.”

The mother, who had previous childbirth experience, nodded even amidst the pain.

The nurses in the delivery room bustled about, preparing instruments, while Tae-kyung and Eui-jin washed their hands and donned sterile gowns.

Meanwhile, blood was slowly trickling from the mother’s vagina, indicating the amniotic sac [the ‘water bag’] had already ruptured.

“Doctor?”

Eui-jin examined the vagina again and addressed Tae-kyung.

“Please apply pressure to the mother’s upper abdomen. The baby’s head is already visible, but…”

Tae-kyung, who usually exuded unwavering confidence in the operating room, seemed different today.

He wasn’t as knowledgeable about childbirth as Eui-jin, and his memory of it was hazy.

In this situation, he had no choice but to trust Eui-jin completely and follow her instructions.

What Tae-kyung knew for sure was that the fifth vital sign was at stage 2.

The strong ammonia smell he had noticed since the mother’s arrival persisted. He was just relieved it wasn’t stage 3 or 4.

Of course, dangerous situations could still arise during childbirth, but Tae-kyung sincerely hoped they wouldn’t and began applying pressure to the mother’s abdomen.

“Dr. Jung, should I push like this?”

“Avoid the right side because of the myoma, and don’t push too hard. Yes, that’s good.”

As Tae-kyung applied pressure intermittently under Eui-jin’s guidance, five minutes passed.

“Yes, good. Put your gown back on and come stand next to me.”

Eui-jin, seeing the baby’s head crowning [becoming visible at the vaginal opening], strongly encouraged the mother while holding medical scissors.

“Mother, good. Now you need to push. Okay! One, two, three, four… a little more, just a little more.”

“Ugh!”

The mother pushed in time with the count.

As expected of a mother giving birth to her fourth child, she followed Eui-jin’s instructions well despite the pain.

“You’re doing really well. Take a breath for a moment. Breathe.”

“Hoo! Ugh!”

“Mother, try not to scream too much; we’re almost done.”

While monitoring the vaginal opening and encouraging the mother, another five minutes passed.

“Okay! Mother, breathe…”

“Hoo!”

“Okay! Push!!”

“Ugh!”

“Last one!!”

“Ugh!”

At this moment, a sense of determination filled the eyes of all the medical staff, including Eui-jin and Tae-kyung.

“Almost there.”

As the baby’s head began to emerge from the vaginal opening, Eui-jin quickly made an episiotomy [an incision to widen the vaginal opening] towards the left rear. Then the baby’s head emerged.

Seeing the baby’s head, she grasped the neck and shoulders and carefully delivered the baby completely, guiding it upwards and downwards.

‘It’s out.’

Tae-kyung thought, watching the baby emerge.

He understood the process of childbirth theoretically, but he realized that such knowledge was meaningless when witnessing it in reality.

In that fleeting moment when the baby entered the world, he felt overwhelmed by a mysterious, indescribable feeling. But it wasn’t over yet.

“Kelly!”

At Eui-jin’s calm but firm voice, the nurse quickly handed over the Kelly clamp [a type of hemostat used to clamp blood vessels].

“Wah!”

Following the loud cry, the mother’s gaze turned to the baby as if drawn by a magnet.

A sense of relief briefly washed over the mother’s face as she was reassured by the medical staff and confirmed the baby was okay.

“Waaah!”

Eui-jin clamped the middle of the crying baby’s umbilical cord with the Kelly clamp and cut it.

Now that the baby was born, she thought she could breathe a sigh of relief, but Eui-jin’s eyes were sharper and more focused than before.

“Dr. Jung, the baby came out well. Good job.”

Tae-kyung whispered to Eui-jin.

“No, Doctor. What comes next is crucial. From now on, it’s even more important.”

“……!”

As soon as Eui-jin finished speaking, Tae-kyung’s expression changed abruptly.

‘What is this?’

Tae-kyung looked down, noticing a strange sensation in his feet. Blood flowing from the vaginal opening was dripping onto his instep.

Not only that, but the floor was already soaked with blood.

‘Damn it!’

Even Tae-kyung, who had witnessed countless surgeries, was taken aback by the volume. Of course, much of it was likely amniotic fluid, but there was still a significant amount of blood.

It’s understood that considerable blood loss occurs during childbirth, but the blood flowing from the vaginal opening showed no signs of stopping.

As Tae-kyung glanced around nervously, Eui-jin grasped the cut umbilical cord and rotated it clockwise, saying to the mother:

“Mother, delivering the afterbirth [the placenta] might be a little uncomfortable.”

“……Yes”

The mother replied weakly.

Eui-jin grasped the umbilical cord and gently pulled, applying pressure to the mother’s abdomen with her other hand.

The placenta seemed to be detaching gradually, but suddenly it tore, leaving a significant portion still inside.

Even Tae-kyung, who had never seen a placenta even as a student, could tell that less than half of it had been delivered.

If the placenta isn’t completely expelled, it can cause severe bleeding in the mother, making complete afterbirth and uterine contraction essential.

A major complication had arisen in this critical process. And at that moment, a low, guttural sound escaped Eui-jin’s lips, who had remained calm until now.

“Damn it!”

The situation was so dire that even Eui-jin, who never used profanity, involuntarily cursed.

But she couldn’t afford to freeze. The two refocused on the mother.

The mother was grimacing from the pain of the episiotomy and the general discomfort in her abdomen. Without anesthesia, she was experiencing the full intensity of the pain.

“Right now…….”

Since there were no restrictions on medication now that the baby was born, Tae-kyung quickly called out to the nurse:

“Give me one ampule of Pethidine [a narcotic analgesic] intravenously (IV).”

“No.”

Eui-jin immediately stopped the nurse who was about to administer the Pethidine.

“Don’t administer it through the IV; give one ampule directly, and give me one ampule of Oxytocin [a drug that induces uterine contraction].”

“Yes, Doctor.”

“Dr. Jung? The placenta hasn’t been fully delivered yet. Is it safe to administer Oxytocin?”

“I’m trying to remove as much of the placenta as possible first, but I believe stopping the bleeding is more critical.”

As Eui-jin answered with a worried expression, Tae-kyung, understanding her reasoning, picked up an instrument for grasping the placenta and handed it to her.

“Give me a speculum [an instrument used to widen the vaginal opening for examination].”

Tae-kyung adjusted the angle of the lighting to give Eui-jin a clear view.

“Ha!”

With a short sigh, Eui-jin continued to explore the vagina with the instrument and soon inserted her hand into the uterus.

“Aagh! Ugh!”

The mother’s cries of pain echoed in the delivery room, but Eui-jin couldn’t stop; she had to remove the remaining placenta. And blood continued to flow from the vaginal opening.

“Check the patient’s blood pressure.”

“Yes, Doctor.”

Eui-jin, after instructing the nurse, continued her attempts to extract the placenta. But even Tae-kyung, standing beside her, could see that her hand was being obstructed by the large myoma on the right side of the uterus.

If bleeding originated from the myoma itself, there might be nothing they could do.

“Ah…….”

Eui-jin was growing increasingly anxious as her attempts to remove the remaining placenta were unsuccessful and the bleeding persisted.

First, she packed the entrance of the uterus with gauze and continued to administer Oxytocin.

“Doctor, please apply pressure with the gauze for a moment.”

“Okay, I got it.”

Eui-jin, realizing she couldn’t manage this complex case alone, quickly made a phone call and stepped outside.

Tae-kyung, assuming she was calling her mentor, continued to apply pressure to the uterus with the gauze.

“……!”

But at that moment, his brow furrowed, and his expression changed.

‘No! Ha! Damn it.’

The patient’s fifth vital sign, which had been relatively stable, had spiked dramatically.