# 26 yo full term 2nd child



## Squirrel (Jun 9, 2011)

Tonight I transported a 26 year old female full term pregnancy, this is her second pregnancy last was delivered via c-section. On scene prior to arrival patient's water broke stating no need to push, contractions "feel like menstrual cramps." 
Vitals were 120/p pulse-90 resp-18 
Patient denies any other complaints, normal pregnancy is on pre-natals and has had healthy checkups. Physical was fine baby was a little anterior we could see his shoulder.

About an hour later my partner is transporting another full term water broke. Arrival at the hospital from the field was 6 mins and she delivered in OB 2 minutes later. While we are unloaded this patient my 26 yo is actively seizing unknown vitals. She is rushed to the OR for a crash c-section. One of the docs there said it may have been eclampsia possible placental abruption.

My question to the community is what else could I have done in the field? Is there anything else I could have done?
I am a private ambulance EMT.


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## Squirrel (Jun 9, 2011)

Also forgot transport time was 2-4 minutes.


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## DrParasite (Jun 9, 2011)

did you drop the patient off in the same or better condition than you found her?

woman have been having babies for thousands of years, long before EMS even existed.  and the majority of childbirths are complication free, and labor takes a while.  hence why most people will drive in the family car to the ER with the bags packed instead of calling 911.

often if complications happen, there is very very little you can do in the field.  if the pregnant lady was seizing when you found her, that's different.

sounds like you did nothing wrong.  in fact, nothing you did or didn't do would have changed the outcome.  best thing would be a rapid transport to L&D so the specialists who have all the tools to best manage a crisis that can occur.


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## Aidey (Jun 9, 2011)

See his shoulder where?


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## Squirrel (Jun 9, 2011)

Thanks dr parasite thats makes a lot of sense. Aidey kinda hard for me to describe we could make out the outline of the baby.


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## Aidey (Jun 9, 2011)

Through her stomach? Via visualization of the external vagina?


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## phideux (Jun 9, 2011)

Squirrel said:


> Thanks dr parasite thats makes a lot of sense. Aidey kinda hard for me to describe we could make out the outline of the baby.



Uterine Rupture?????


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## abckidsmom (Jun 9, 2011)

Squirrel said:


> Thanks dr parasite thats makes a lot of sense. Aidey kinda hard for me to describe we could make out the outline of the baby.



During a strong contraction, you can sometimes make out the shape of the baby, especially if the amniotic sac has ruptured.  This is pretty normal, and pretty freakish, IMO.  It felt like something out of a sci-fi movie.


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## usalsfyre (Jun 9, 2011)

The only thing I would say is that a systilic pressure of 120 in the gravid patient could be considered hypertensive (although not greatly so, especially in a third trimester patient).


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## bigbaldguy (Jun 9, 2011)

Wait a minute? Babies come out of women? Whaa? I should have paid more attention in class.


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