Thursday, March 6, 2008

Mama Miracles and Baby Wonders

Sometimes medical jargon conceals the most amazing dramas:
A multiparous patient was admitted at 29 weeks of gestation for conservative management of placenta previa. She complained of intermittent abdominal pain, but repeated assessment suggested that both the patient and the fetus were doing well. At 36 weeks, an abdominal pregnancy was diagnosed with radiological features suggestive of uterine rupture. Laparotomy was performed and a healthy infant was delivered. (Obstetrics & Gynecology 2008;111:502-504)
If you've had a baby, you've probably deciphered the jargon already, but indulge me while I play up the drama.

You get admitted to the hospital while 29 weeks pregnant, at a point where your baby would likely survive outside the womb, albeit after weeks in intensive care. You've got a bellyache, but it's like when you take your car into the shop: the problem is intermittent and no one can see anything wrong with you.

Seven weeks later (!) someone figures out that you're carrying this baby outside the womb already. It's hanging out in your abdomen, because while no one was looking your uterus ruptured. By then you're far enough along for surgical delivery, which is a darn good thing since that's the only way that baby gonna come out. Incredibly, you survive, and so does your baby.

The doctors' dry summary is almost hilarious in its understatement:
Advanced abdominal pregnancy is rare, and one that occurs after uterine rupture with delivery of a viable fetus is exceptional.
Exceptional? This is a double miracle. The mother in question already had placenta previa, which meant she was at serious risk of hemorrhage because the placenta was covering the cervix. (In other words, the conventional exit route would've been a problem for that fetus anyway.) Uterine rupture is also commonly fatal, especially when not diagnosed promptly. By rights, both mother and baby should've died.

I'm not sure why this story hasn't made it into the popular media. (If it has, I missed it.) Maybe because the woman is Malaysian and the hospital is in Kuala Lumpur. Now that the writer's strike is over, it'd make a great storyline for Grey's Anatomy. Only thing is, skeptical viewers like me would scoff that it could never happen.

And by the way, I don't really believe in miracles, literally. If he or she is benevolent, the same puppetmeister god who dispenses miracles could've prevented that uterine rupture in the first place (just for instance). But it's funny, we don't have language adequate to this without turning metaphysical. Now, if you told me the Ceiling Cat was responsible, I'd believe it. A feline deity might be benevolent – or not – but she'd definitely be capricious and random.

Divine feline from I Can Has Cheezburger?


ThePoliticalCat said...

Yes, I rather like the idea of a feline deity. It would certainly explain why life was so ... is "fucked up" the term I want?

As mice to wanton cats are we to Ceiling Cat
She kills us for her sport

With apologies, of course, to the original Bard, and for failing to render it appropriately in lolkitteh.

Sungold said...

I'm not sure my comments support Lolkitteh, anyway. But your verse sure captures the human (and murine) condition.