Nathan was on call on our baby girl’s birthday and helped deliver twins. Here is the story of the little girls that share our daughter’s birthday.
My next patient was K. She was pregnant with twins and had been referred from the maternity clinic secondary to elevated blood pressure. I rechecked her blood pressure which was still high and after a simple urine test determined that she had preeclampsia. I explained the diagnosis to K before we headed to L&D. Preeclampsia is a condition that can arise in the 3rd trimester of pregnancy resulting in high blood pressure and multi-organ dysfunction which can lead to seizure and death. The only treatment is delivery. K’s twins were both transverse (lying crosswise) which would require a C-section.
By the time we got K into the operating theatre her blood pressure had climbed into the 170s. She now had severe preeclampsia. One of our visiting PNG medical students joined me to assist with the surgery. In the midst of all the preparation we paused for “Time Out” to verify we had the correct patient, correct procedure and to pray. “God, help K and her children. Help them to walk with you. Guide us in our work.”
A few minutes later I was grabbing Twin One’s feet and pulling her out through the uterine incision. “Its a girl!” But she was very pale, not moving and crying. Stimulation and suction did nothing to change the baby’s situation. I handed her to one of our nurses to care for. I’m worried but generally most kids respond well within 30 seconds. I have to go get Twin Two. As I was working to get Twin Two’s feet, Bosip, our nurse anesthetist, hollers at me. Twin One is not breathing and her heart rate is 50-60 so the nurses start CPR and intubation.
I finally get Twin Two delivered, feet first, with some difficulty. She is also pale, limp and not crying. Now I have two twins, neither of which is doing well and a mother with an open uterus. We quickly called in Dr. Sheryl, one of our surgeons, to help ASAP!
I am giving directions to our nursing staff regarding the girls while I work on Mom. Dr Sheryl arrives to care for K and I start working on both girls. By now both babies are intubated and receiving chest compressions. We get them on oxygen, give epinephrine. Stressful minutes tick by as we try to save these two precious girls. After 10 minutes they are both still pale, limp, not breathing normally and have heart rates of 50-60 (very low). While I count off CPR compressions, I face the very real prospect of having to tell K and her family that we lost her children. As I run through further treatment options in my head I realize we have done everything we can do except pray. “God, we need a miracle! Please save these girls.” We continue CPR: 1 and 2 and 3 and..the compressions rapidly go. A minute later Bosip looks at me from the warmer of Twin One. “Doctor this child is breathing on her own!” He extubates her and she begins to scream! “Thanks God! We need one more miracle.” Twin Two’s heart rate comes up to 120s (normal) and she starts breathing on her own. She is still limp and pale but improving. After several minutes both girls are doing well enough we transfer them to the nursery for further observation. By the next morning both girls are breast feeding and doing well. No small miracle considering how long it took to get them breathing on their own.
Three days later I was on call again and saw K. It was time for her discharge. She was unaware of what had happened in the delivery so I shared with her the story of the night her daughters were born. As I finished I said, “I want you to know God worked a miracle to give your two daughters life. When you look at them remember God loves them and cares deeply for you.” Tears of joy filled her eyes as she realized the miracle God had performed.
We serve an amazing God.