Kate Hardy - The Consultant's Christmas Proposal

Placental abruption was when the placenta separated from the wall of the womb. Blood accumulated between the placenta and the womb, forcing the placenta to tear away even more. In severe cases, the baby wouldn’t get enough blood and oxygen and could die. For the baby to survive, at least half the placenta needed to stay in place.

‘Patient history?’

‘Thirty-two weeks gestation.’ So, if she needed to do an emergency Caesarean section, the baby had a decent chance of survival. That was good. ‘The mum’s having contractions, says she feels sick and faint, and she’s very thirsty. She’s complaining of abdominal pain, and her abdomen’s tense.’

Not so good: it sounded like a severe abruption.

‘What have you done so far?’

‘She’s on oxygen, we’ve got an IV line in and we’ve checked the baby’s heart rate. It’s low.’

‘OK. I’m on my way down. I need a portable ultrasound, six units of blood cross-matched, and can you get her bloods checked and let me know the platelet count, please?’

‘Will do.’

‘Great. And can you bleep the anaesthetist, please, in case we have to go straight to Theatre?’

‘That’s my next call.’

‘We’ll need Paeds as well—I want Mr Barker, if he’s available.’ Things between them might be a little cooler than usual right now, but he was the best doctor for the job, the doctor she’d most want to work with in this situation. They’d always worked well together, been a real team. That wasn’t going to change.

‘Will do.’

In the emergency department, she introduced herself to Pippa Fletcher. ‘What we think has happened is that when you had the accident and your tummy banged into the steering-wheel, it caused your placenta to tear away from the wall of your womb,’ she explained. ‘This means you’re losing blood, which is what’s making you feel sick and dizzy.’

‘Is my baby going to be all right?’ Pippa asked, her voice shaky.

‘We’ll do our best,’ Saskia reassured her. ‘We may have to give you a Caesarean section and deliver the baby.’

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