After OpenOffice for Ubuntu crashed its presentation program for the third time, I decided to go low tech, using chalk and chalkboard for a talk at the Monday hospital staff meeting. I promoted the use of aspirin for women with a history of preeclampsia, given recent findings suggesting that early abnormalities in placental vasculature that lead to preeclamapsismay may be prevented by aspirin. And I encouraged the use of misoprostol for postpartum hemorrhage, which is in their protocols but not in their pharmacy--at least it wasn't until I gave the pharmacist the 100 I had brought with me.
After the meeting, I was introduced to Labor and Delivery, where I was asked about a woman making poor progress in labor--the staff suggested a C/S. The hospital has C/S rate of about 20-25%, comparable to the U.S. Higher than I would have expected prior to the Mozambique trip where I appreciated that it is better to perform a few extra C/S's than to have vaginal deliveries of babies in need of non-existent resscitation. As in Mozambique, the nursery here consists of a single warmer where newborns stack up waiting for their mothers' recoveries.
Although augmentation of labor with pitocin would an option for slowly progress, given the long labor so far(unexpected for someone with prior deliveries) and her request for a tubal ligation, I agreed with the C/S. The baby was 3700 grams (over 8 lb), a probably cause for the stall. Afterward, when one of our nurses asked the mom what name she planned, she said, "you name it." The nurse suggested David, and David it was.
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