Recurring Nightmare 2

Please read Foreword first.


Recurring Nightmare – O&G

Your lunch is interrupted by a page from the A&E. Per vaginal bleeding, positive urine pregnancy test.

Young woman, found to be pregnant last week. First pregnancy. No scan so far. Sudden onset of pain this morning at work followed by PV bleeding which has since resolved. Her colleagues sent her here. Her husband is on his way.

You ask her to lie down and you do a scan. The uterus is empty. No adnexal mass or free fluid.

You call the OT Reg for the day. She says they can fit her in after the last case, say about 4 pm. Get a consent.

You pull a chair and sit down by the young woman's trolley. You tell her the baby is gone. She starts to cry.

You tell her up to 50% of pregnancies end in miscarriages. You tell her sometimes women wouldn’t even know they have had a miscarriage but just thought their menses were late.

You tell her it wasn’t her fault and there was nothing she could have done to prevent it from happening. You tell her that even though you didn’t KNOW that was the truth.

You don’t know if she believes you. You’re not even sure she is listening.

She’s probably thinking about what her husband will say. She’s probably thinking about what her mother-in-law will say.

She’s probably wondering whether she can get pregnant again. She’s probably wondering if she has become less of a woman now.

You tell her you need to do a 'procedure' for her to clear whatever 'products of conception' which may still be inside the womb to make sure the bleeding stops. You tell her it’s OK to wait for her husband to come before she signs the consent, but she decides to sign it now.

She wipes her tears dry with her sleeve, takes your pen and signs on the line, and then thanks you.

You give the excuse that you have to arrange her case with the OT and leave her with her thoughts.