smallfrymedic Posted May 21, 2006 Share Posted May 21, 2006 You hear about these things but dismiss it as urban myth. My partner and I did a stat transfer call from our local urgent care clinic to an across town hospital L&D for an obs consult. Turns out the pt may be pregnant and didn't even know it! What's even better is she may be in labour. However, the whole thing is sketchy! Call comes in (dispatch info): 22 y/o female, 24 weeks gestation, in active labour. Pt, 80kg, 22y/o F, walks into the urgent care clinic in the late morning. HPI: she states she felt like she was constipated (BM urges with no passing of stool). Reported diarrhea x2 days, with abdo pain late yesterday and again early this am. On one occasion she says she was on the toilet straining and reports a “vag prolapse” that retracted when she stopped straining. Pt got concerned and is what lead to her clinic visit. No rupture of membranes reported. While at the clinic she was examined by the doc. He states he did a digital vag exam (no speculum). While he was parting the labia he was presented with a bloody show. He became suspicious of a possible pregnancy but couldn't confirm it (pt was unable to void for urine test, and they don’t have the capacity for bld test at the clinic lab). He also states he found a poss. FHR of 181 BPM (Doppler) in the LLQ. PMHx: Pt states she has no allergies and no medical hx, she has been on regular birth control and has regular menses but lighter than norm. O/E: NAD found on hosp bed CAOx3, norm skin (pink, warm, dry), apyretic , norm resp effort, midline trach, no JVD, H/S ok, symmetrical chest clear AtoB, abdo (not palpated) mildly distended, unremarkable back/pelvis, extrem: good ROM/CSM/turgor/ bilat radial pulses. V/S: HR: ST 110-120BPM, RR: 16-20BPM, BP: 134/82, SaO2: 99% RA, GCS: 15, pupils: 4mm pearl. While in the care of EMS pt had brief 30sec cramping/ contraction? So, what do you think, pregnant/labour? Follow-up to come… Link to comment Share on other sites More sharing options...
Dustdevil Posted May 21, 2006 Share Posted May 21, 2006 Wouldn't be the first woman I've known to give birth without knowing she was pregnant. Doesn't sound exceptionally probable with this broad, but for them to put a specific gestational age on her, there must be some pretty significant evidence. Or else the doctor is a dork. It might be a tumour. What was her temp? P.S. I only understand about half of your abbreviations. Link to comment Share on other sites More sharing options...
PRPGfirerescuetech Posted May 21, 2006 Share Posted May 21, 2006 ummmm, ultrasound? WTF? Link to comment Share on other sites More sharing options...
hammerpcp Posted May 21, 2006 Share Posted May 21, 2006 No ultrasounds at this clinic. Link to comment Share on other sites More sharing options...
ERDoc Posted May 21, 2006 Share Posted May 21, 2006 Might have gotten gestational age from fundal height. Could be pregnant, could be fibroid. Guess we'll wait and see. Link to comment Share on other sites More sharing options...
hammerpcp Posted May 22, 2006 Share Posted May 22, 2006 L&D= Labour and Delivery OBS= Obstetrics PT= patient kg=kilogram F=female HPI=history of present illness BM=bowel movement abdo=abdominal AM=ante meridiem Vag=vaginal doc=doctor bld=blood FHR=fetal heart rate BPM=beats per minute LLQ=left lower quadrant PMHx=past medical history hx=history norm=normal O/E= on exam NAD= (not sure about this one) no anal discharge? just guessing. CAOx3=conscious alert and oriented resp=respiratory trach=trachea JVD=jugular vein distention H/S=heart sounds A to B=apices to bases extrem=extremities ROM=range of motion CSM=circulation sensation motor/movement bilat=bilateral V/S=vital signs HR=heart rate RR= respiratory rate BP=blood pressure RA=room air GCS=glasgow coma scale mm=millimeters pearl=pupils equal and reactive to light EMS=emergency medical service/system Did I get them all? :wink: Link to comment Share on other sites More sharing options...
hammerpcp Posted June 1, 2006 Share Posted June 1, 2006 I can't take it any more! I have to spill the beans because this was definitely the weirdest call I've ever had (well, one of them anyway). So we informed the L&D nurses that we would be following up the next day, and they were completely cool with that so we did. Guess f&*^ing what! Shortly after we dropped this pt off she went into full blown labour. A six lbs, apparently healthy and normal baby boy came popping out into the world. Gestational age estimated at 38 weeks. I don't think even sky writing would have helped in this case. :wink: We went to go see the little dude and he was the cutest thing, with a complete head of hair and snoozing away. I felt like a proud mother (ridiculous I know). Link to comment Share on other sites More sharing options...
Eydawn Posted June 1, 2006 Share Posted June 1, 2006 Surprise surprise! Good thing the kid's healthy and all. How's mom dealing with it? How could you not know you're pregnant, that far along, is what I want to know! Are people really not in tune with their bodies? Wendy NREMT-B CO EMT-B MI EMT-B Link to comment Share on other sites More sharing options...
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