MY LAST CS

MY LAST CS

Dr. Gangadhar Sahoo

It was the 4th of October 2019. I was the dean IMS and SUM Hospital Bhubaneswar as well as head of 2nd Unit, Dept of ObGyn . I was on the morning round with all my 2nd unit faculties and postgraduates. I went to the delivery room to see my niece who was shifted from her cabin with profuse  blood stained watery  discharge per vaginum.
She was a primigravida carrying 28 weeks of pregnancy. She was staying at Cuttack under the regular check up of a senior gynaecologist owning a nursing home. One night she had watery discharge per vaginum carrying 26 weeks of pregnancy. The consultant, apprehending a premature delivery, expressed his inability to admit and treat her as his hospital was not equipped  with a standard neonatal care facility. Then my brother-in-law who is a renowned advocate of Cuttack consulted other famous gynaecologists of the city  but in vain. At last he consulted me. I advised him to shift her  immediately  to our hospital which had a well equipped neonatology unit with NICU facilities. He did so without a second thought. He felt secure when his daughter-in-law got admitted to our hospital.
 She was admitted as a case of "PrimiGravida 26 weeks pregnancy with breech presentation, placenta previa, fibroid uterus and PPROM". The HOD of neonatology Prof. Sahoo was consulted. Our plan was to prolong the pregnancy as many days/weeks as possible with the motto, "an hour of prolongation of intrauterine stay counts." All precautionary measures were taken as per the decision of the team composed of senior gynaecologist, neonatologist and anaesthesiologist. Intermittent watery discharge and sometimes blood stains were continuing. Almost two weeks passed. Expected fetal weight had increased to around 900 grams. Measures were taken for pulmonary maturation and neuro-protection. On that fateful night of 4th October she had a bout of blood stained watery discharge. Ultrasonography revealed no liquor in the amniotic cavity.
Decision for CS was taken. I myself decided to do the surgery judging the multiple problems of the case. Prof. Nayak, my next senior faculty of my unit assisted me. In the presence of a senior neonatologist the LSCS was done under spinal anaesthesia. This CS was one of the most difficult CS in my life. I had to fight against multiple obstacles like a thick lower uterine segment, anterior placenta just below the incision, breech presentation and uterine walls gripping the fetus tightly. However Prof. Nayak who was assisting me took away my pressure and stress by delivering the very premature baby girl skillfully and smoothly. The was asphyxiated, lethargic, having bradycardia. Anyhow, the expert neonatology team took care of her. After intubating they shifted the baby to the NICU. Against all odds the baby survived due to the dedicated service of the neonatologists. My kudos to the whole team. She had to stay in the NICU for more than two  months. A very costly baby was delivered to the parents. She was added to the list of success stories.
At the beginning one of the senior and famous gynecologists had advised me not to take the risk and terminate the pregnancy. But it was my good luck that I came out victorious in the battle of life and death. That girl has gone to school . She is reading in class 1 of Sai International School Bhubaneswar. She is outstanding in all her activities. She can outsmart anybody. She is so brilliant that she can sell me in the market a thousand and one times.  Undoubtedly she is a gifted child. Pray Lord Jagannath to bless her.
That was my last surgery. After that I continued as Dean till the 31st May 2022 , my date of superannuation. After my retirement I left my clinical practice. In my whole clinical career I must have faced a good number of difficult cases but this case is unique.
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Prof Gangadhar Sahoo is a well-known Gynaecologist. He is a columnist and an astute Academician. He was the Professor and HOD of O&G Department of VSS MEDICAL COLLEGE, Burla.He is at present occupying the prestigious post of DEAN, IMS & SUM HOSPITAL, BHUBANESWAR and the National Vice President of ISOPARB (INDIAN SOCIETY OF PERINATOLOGY AND REPRODUCTIVE BIOLOGY). He has been awarded the BEST TEACHER AWARD of VSS MEDICAL COLLEGE,BURLA in 2013. He has contributed CHAPTERS in 13 books and more than 100 Scientific Articles in State, National and International Journals of high repute. He is a National Faculty in National Level and delivered more than 200 Lectures in Scientific Conventions.He was adjudged the BEST NATIONAL SPEAKER in ISOPARB NATIONAL CONVENTION in 2016.