Nineteenth Century Medical Guide

Chapter 371 367. Obstetric Killer

【Take care of the kids yesterday

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With this voice, Alex almost shouted out that Melanie had high blood pressure.

The Danish royal family, the daughter-in-law of the Queen of Great Britain, and probably the future queen of the empire, actually had her membranes ruptured under his nose, causing amniotic fluid to flow all over the floor.

She had just been pregnant for a short period of time, and she had promised to have servants accompanying her to take care of her, but in the end it was just Asi, with nothing else. When people arrive and can't be driven away, who would have thought it would be like this? If he had known this, he should not have asked Asi to invite the people in the first place.

"Just now it was the prince, and now it is your majesty the princess."

"What's going on? It's so scary!"

"She must be giving birth. I was like this at the beginning. When I was about to give birth, it was like someone poured a whole basin of cold soup on my skirt. The skirt and carpet were soaked. Not to mention how uncomfortable it was."

"It seems we can't see the art exhibition."

Trouble is trouble, and the hostess still has to try her best to control the chaotic situation in front of her. Especially since it is still raining now, rather than watching them disperse in the rain and leaving a messy bad reputation for themselves, it is better for them to stay here peacefully and not go anywhere.

"Madam, do you want to find a doctor who can deliver babies?"

The situation is stable, and this is the third pregnancy. Although it is not as good as a woman in her 30s who has given birth many times, she is still quite experienced, and the labor process will not exceed 8 hours.

There was a professional obstetrician present and the matter was handled properly, so there was no need for Kavi to interfere. He stood aside. After checking the cleanliness of the amniotic fluid, he naturally gave up the position of attending clinic: "I don't know much about natural childbirth, so I'd better listen to you. I'm just helping."

Maybe this is the blessing in misfortune.

"no problem."

"When you are about to give birth, you should also prepare warm water to wash away the dirt on the baby's body, and warm clothes."

"Does Dr. Carvey have any suggestions?"

For example, body temperature (normal), maternal heart rate (93 beats/min), approximate fetal heart rate (around 120-150 beats/min), and whether there is edema in the body (none). Then simply feel the belly and roughly calculate the palace height (28cm), abdominal circumference (97cm) and fetal position (cephalic position).

The old man looked at Kawei who was standing behind her, and wanted to refuse, but he couldn't resist Melanie's face and stepped forward first, while giving in: "How long has the princess been pregnant?"

Most of the people attending the exhibition chose to stay, and there was no need to disrupt their pace due to unexpected circumstances. A small number of people inevitably chose to leave. Sometimes people's moods are so strange that it would be torture to stay without them.

As mentioned before about Alex's situation, she hired an obstetrician for safety reasons. He had just retired two years ago, and his reputation was as good as that of Hugier from the Main Palace Hospital, and his technical prestige was also very high.

"That's 36 weeks. She was born prematurely. It doesn't look like there's much amniotic fluid." Dr. Samuel leaned over and took a look, then said to Melanie, "Countess, it's raining so hard outside. I think it's... Let’s give birth here. It’s best to prepare a comfortable bed, some warm water, cotton cloth, and, yes, scissors.”

"It's 8 months and 12 days." said Frederick, who was lying aside. "I'm helping her count the days."

If that doesn't work, at least she has Kavi by her side, which is double insurance.

"More than 8 months, maybe 9 months, alas, I forgot too."

Melanie no longer cares about the salon, as long as the young Danish royal brothers and sisters are safe, that is better than anything else.

Once priorities are sorted out, retired directors like Samuel will easily get back to their original work status and have everything in place.

"Everyone, don't worry, just follow me to the main hall first." Melanie raised her voice, attracting the attention of most people, and pointed to the door on the side, "The bodies of His Majesty Frederick and Alex are It’s uncomfortable, we need to clear this place and give them some private space.”

"Doctor Samuel, you'd better take a look." Melanie still led the white-haired old man forward, "She is the Princess of Wales, what should I do now?"

And Kawei is mainly responsible for some content that only he cares about.

"Ok."

This is still a conservative estimate. If the princess exerts her strength steadily enough, she may be out in 6 hours.

Now the membranes have ruptured naturally, the amount of amniotic fluid doesn't look too much, probably less than 500ml, it looks clean, and the fetal position is still in a good position. In their eyes, such a multiparous woman is like an automatic loom. After the baby comes out, just help cut the umbilical cord and then remove the placenta. Any experienced midwife can do it independently.

The only thing that needs special attention is that the environment must be clean enough to avoid childbed fever.

Only then did Kavi discover that Samuel, like Semmelweis, was very keen on washing his hands. After a brief exchange, they spoke highly of Semmelweis's "washing hands".

"I expect it will only take 5 hours to finish this accidental job." Samuel asked, "When the matter is finished, is Dr. Carvey interested in chatting?"

It was hard for Kawi to refuse the invitation of an old man who had worked in the delivery room for decades. He was also interested in midwifery and happened to be free today.

Just when he was about to agree, Alex, who was lying quietly on the coffee table with her legs raised, suddenly said: "Doctors, I feel it. There seems to be something coming out from below. It feels weird. Please help me." Look, it’s not a child.”

"so fast?"

The first reaction of both of them was surprise. The so-called "coming out" was nothing more than the fetus starting to give birth and exposing its head. This requires full dilatation of the cervix, which means the end of the first stage of labor. However, less than two hours have passed since the membrane ruptured, which is too fast!

Kawei smelled an unusual smell, but out of the protection of Her Majesty's privacy, he still did not come forward. He just asked: "Dr. Samuel, when you did the examination just now, what was the position of the fetus?"

Samuel immediately understood the meaning of Kawei's words: "It's the number one position, I swear!"

"I also checked the head position." Kawei frowned and became more worried, "This is very strange."

"Your Majesty, I'm sorry, I need to do another check-up."

"Please."

Samuel stepped forward quickly, lifted up her long skirt and put his hand in it without waiting for her consent. The examination ended quickly. The old man's face was extremely solemn. Apart from some simple comforts, he didn't say a word during the whole process.

"Doctor, has the baby come out?" the princess asked.

"Um"

"It's so strange. Why is it different from the first two babies?"

"Can you tell me whether it's a nephew or a niece?" Frederic, who was holding his stomach and crying out in pain just now, seemed to be much better now, leaning on the sofa, "I'm going to visit the best restaurants in Paris in the afternoon. Children's clothing store, his first piece of clothing must be given by me!" Samuel said with a smile: "The child hasn't come out yet, so I can't be sure yet."

Melanie, who had been waiting at the door, also noticed something strange: "Dr. Samuel, is there anything I can do for you?"

"Not yet, thank you."

The old man answered faster and faster, and his steps became more and more urgent. Kawei knew something was wrong. After he washed his hands and came to his side, he lowered his voice and asked, "What's wrong?"

Samuel felt like a stone was stuck in his chest, and he was panicking: "The child's shoulder fell out!"

"Shoulders exposed first? But just now it was in the head position, why did it suddenly change to the horizontal position?"

"I can't understand it either, it's so weird!"

After all, Kawei is not an obstetrician, so he doesn't know the high position factor of shoulder presentation. However, after seeing the semi-dried water stains on the carpet, I thought of a possibility: "Perhaps after the natural rupture of membranes, the amniotic fluid overflow caused the volume and pressure in the uterine cavity to change, turning the original head position of the fetus. For the horizontal position.”

"Self-transposition? Is this possible?"

"It's possible to be born prematurely, although it's only two weeks early."

"You should know that this is the most unfavorable fetal position for the mother and fetus, and it is one of the most troublesome situations in obstetrics. I think she should be sent to the hospital immediately without delaying it any longer!"

Kavi also agreed with him and needed to be sent to the Citadel Hospital immediately. Hugill was there, and there were many midwives who could help, including the oxytocin he had brought. But the problem was that it was raining heavily outside, and the streets in Paris were not very smooth. Even riding a carriage would take time.

"Mr. Aspen."

"Well, what happened?"

Kawei immediately made a judgment: "Mr. As, please prepare a carriage immediately. We need to transfer Her Majesty the Princess to the Main Palace Hospital."

"Go to the hospital? Why do you want to go to the hospital?" The brother and sister asked almost at the same time, "Is there something wrong with the child?"

Kawei did not hide it, because it was too late to hide it anymore. What he and Samuel needed most now was the cooperation from the mother and her family: "Originally, the head should be exposed first, then the body and limbs. Now it is exposed first. An arm, so you don’t feel the same as before.”

The two of them became nervous: "Is it dangerous?"

"It's really dangerous if you don't go to the hospital."

Asi's reaction was very quick. He didn't ask anything. He just suggested: "It takes at least 20 minutes to go to the Main Palace Hospital from here, which is the speed of cracking a whip. It's raining heavily outside now. If you want to ensure safety, time is very short." Possibly double that.”

This is after excluding the preparation time of asking someone to prepare the car. It is fast within an hour.

What is "fast" in the eyes of outsiders is not fast in the eyes of Kawei and Samuel, at least not fast in the face of "shoulder first".

"How about going to another hospital first?" Samuel suggested.

"No." Kawei shook his head, "Other hospitals don't have the surgical instruments and medicines I use."

Samuel looked at him in disbelief: "Surgical instruments? Do you want to perform a cesarean section on the princess?"

"If you want the mother and child to be safe, you can only choose a cesarean section." After thinking for a moment, Kawei suddenly said, "But the princess is already the third child, and the membranes naturally ruptured, and now the cervix is ​​partially opened. If Samuel If the doctor can perform fetal inversion and has the ability to use forceps to deliver the fetus, surgery can indeed be a temporary alternative. "

As a young man, Samuel studied under Du Bois.

What this teacher is best at is using inversion surgery and forceps to help deliver non-cephalic fetuses. He was considered the favorite doctor of Parisian women during the period when "dystocia = waiting for death". Samuel's skills are not bad either, and his many years of practice have given him his own customary tire-changing techniques.

However, no matter how powerful a doctor is, how calm he is when faced with problems, or how objective and accurate his judgment is, he will inevitably have many concerns when he really meets a "noble person" and is not allowed to fail.

Samuel rejected Kawei's proposal: "I think it's better to send him to the main hospital. Staying in the salon will have no good results."

"Didn't I just say that it will take an hour on the road." Kawei's concerns were completely different from his. "A lot of things will happen in this hour. The key is not how serious what happens, but when something happens. , the princess will be trapped in the carriage, even if we go together, it will not help. "

"But you have to know that fetal inversion surgery is not that simple. What if you can't handle the uterine rupture?" Samuel argued in a low voice, "You can't just focus on those external factors and digest all the internal factors related to personal skills. Damn, I’m not as confident as you!”

At this point in the discussion, we can no longer tell who is right and who is wrong. The situation they face is stuck in a strange position, neither advancing nor retreating.

"what to do?!"

"Mr. Asi, no matter what the final result is, we need you to prepare the carriage, including all the necessities needed for delivery. We will use it at any time!" Kawei verbally informed a list of items, "Please make sure Driver skills, that’s important.”

"I will handle it!"

Time waits for no one. If she stays on the long coffee table in the salon for even one minute longer, the danger she faces will increase. Seeing that Samuel was still hesitating, Kawei became anxious: "Dr. Samuel, do you know what problems you will encounter if you don't deal with shoulder presentation first?"

"I know that uterine contractions can be weak, causing difficult labor. Sometimes the umbilical cord can fall out, and the baby may not be saved."

Hearing that the child was in danger, Alex finally spoke: "Two doctors, please save the child!"

"No, Alex!" Frederick said quickly, "Your first two births were sons, and they were all healthy. You have done your best. Now that you are in danger, you can't act recklessly. Albert I do like to flirt with women, but I know he loves you and he will definitely forgive you! "

However, the current situation has gone beyond the control of the princess and has vaguely become a diplomatic issue between Britain and France.

While everyone was still thinking about whether the mother and child were safe, aside from medicine, the only one who truly understood this level was Melanie, the hostess of this villa and mansion.

Living in the palace and upper class society all year round gave her a good political acumen. If the grandson of the Queen of England died at the French countess's salon exhibition, no need to elaborate on the reason, just putting this headline on the newspaper headlines would make Naisan angry.

Therefore, "If you want to protect the princess, you must also protect the child!"

Melanie leaned into Kawei's ear and said.

(End of this chapter)