Student Midwives getting learning opportunity to handle critical cases at Rajshahi medical college hospital
Written by Dr. Tamanna Nusrat Eshika, Clinical Mentor, Rajshahi
Sharmin was a 24 years old expecting mother with full term pregnancy. She had high blood pressure with massive swelling in both legs and respiratory distress. Sharmin got admitted in the Gynae & Obs. Department, Unit-3 at Rajshahi Medical College Hospital on 19th November 2018 around 7:30am. Roushan Ara, a certified midwife who was also the nursing in-charge, received Sharmin at the ward. Five student midwives in their third year were present there at that time. Just after receiving the case, she analyzed the severity of emergency and immediately shouted for help. The duty doctor diagnosed Sharmin with pre-eclampsia condition. With the advice of the doctor, student midwives took immediate initiatives to manage the case by placing the mother appropriately, checking vital signs such as pulse, blood pressure, respiratory rate. Simultaneously other students were checking fetal heart rate and uterine contraction.
Under the guidance of the attending doctor, student midwives injected magnesium sulphate to stop convulsion. They also started Injection Labetalol slow IV to control the high blood pressure. The student midwives monitored the blood pressure at a 15 minutes interval. One of them were monitoring respiratory rates and urine output to avoid magnesium sulphate overdose. Time to time they updated the medical officer and the nursing in-charge.
After about half an hour, the mother’s condition improved. Her blood pressure normalized, her progress towards labour and fetal heart rate was good. The midwives were giving continuous psychological support to the mother and her attendant. In consultation with the doctor, the student midwives prepared for delivery. Sharmin now felt stable and much more confident.
Finally, at 9:17am Sharmin gave birth to a baby boy. The midwives provided skin-to-skin of the baby with the mother, did delayed cord clamping and initiated breast-feeding. Learning and experiences will help to build the confidence of the midwives on managing eclampsia cases and handling critical situations.