A tragic story of how a woman died of Placenta Previa complications

Horror stories of placenta previa death and complications as shared by a medical doctor 

Antenatal_Care
#Placenta_Praevia
#Maternal_Mortality

I’M VERY, VERY SAD.

I don’t know why the past few days had been terribly terrible for me.
I got a call that I lost a dear female friend who was in labor due to what we call PLACENTA PREVIA.
And the bad side is that she didn’t go to the hospital more than once.
The only time she did at, 8 months of the pregnancy (32 weeks), she was asked to do a scan and it showed what the situation was.
The doctors advised that at nine months she’d repeat the scan and if it remained the same then she’d need a CS (Caeserian Section).
But babe didn’t want a CS cos she wanted to deliver like the HEBREW WOMEN.
Yet again, the same story in Nigeria.
Now she went to a traditional birth attendant (TBA) to be delivered when she went into labor. The TBA, on seeing the emergency nature of the labour, did not know she had placenta praevia (TYPE 4) and then attempted to do a vaginal exam.
Blood of Jesus 😨😨
It provoked a lot of bleeding as would be expected. The bleeding was torrential. And before she could be rushed to the hospital, she lost a lot of blood and went into hypovolemic shock, then died this morning at the hospital somewhere in the southeast.
I am really heartbroken 😭😭
The more painful part was that I spoke to her about this last month when she mentioned that doctors told her she had placenta previa after doing a scan.
But of course she didn’t listen to me or to her doctors there in the hospital. The easily preventable high rate of maternal mortality in Nigeria is what is paining me like mad.
As far as I’m concerned, there are three big causes of this stratospheric nature of maternal mortality in Nigeria.
I call them R I P
R – Religion
I – Ignorance
P – Poverty

The three are a deadly combo:
Religion will make you think you’re a Hebrew woman. Ignorance will make you not take your doctors seriously. Poverty will make you run away from the bills cos it’s too expensive for the average man, but not so when compared to the cost of life.
So briefly, we are going to look at placenta previa in relation to antenatal care. We would love to know what it is and why it is so dangerous.
The aim of this post is to let you understand why antenatal clinic visits is important.
You see, antenatal visits are extremely important. It’s not child’s play. This is because no two pregnancies are the same even in the same woman.
Pregnancy is like a journey to a known destination, but each time you go there, the safety of the journey is not always certain.
Imagine going from Lagos to Abuja. You know your destination and even if you know the road to take, but you don’t know what could happen along the road:
Armed robbers could waylay you, there could be an accident, the tires could burst. A lot of things could go wrong.
So that means that no matter how many times you had gone from Lagos to Abuja in the past, you still have to be very careful each time you want to make a fresh journey.

That’s exactly how pregnancy is
So the first time a woman comes for antenatal clinic visits, the doctors try to ask her some questions about her past sexual and reproductive health and other aspects of her health (history taking). Secondly, the doctors examine her to see if she has any obvious issue that needs to be taken care of (physical examination). Lastly, the doctors order some tests (investigations). Some will be requiring the blood or urine, in some very rare cases, stool.
These three are the tripod of clinical practice before you even begin to treat the woman or any patient for that matter.
And because no two pregnancies are the same even in the same woman, a woman who had no problems in previous pregnancies could have a big problem in a new one. And if she didn’t register for the antenatal clinic visits early enough and back it up with regular visitation, she may put herself at risk.
Each time a woman comes for antenatal clinic visits, the nurses usually measure her BP and examine her urine

They also measure weight and height too, especially for those coming for the first time. As part of the investigations, we ask them to do scan.

Usually the scans could be early, middle or late, and each of them tells us something different.
Why I’m taking this preamble is to let you understand the reason antenatal is important.
During such visits, we could realize that
~ A woman who was never diabetic, now suddenly has diabetes in pregnancy. We call it Gestational Diabetes Mellitus. And it’s not good at all.
~ We could realize that a woman who never had high BP, had suddenly developed one. We call it PIH – Pregnancy-Induced Hypertension.
~ We could find out that a woman who had normal blood level, suddenly now has low blood. We call it Anemia in Pregnancy.
~ An ultrasound scan could tell us that the baby of this woman is very big and it’s a problem. We call it foetal macrosomia.
~ We could find out that the placenta that’s supposed to be on the ceiling of the womb is now on the floor, or about to block where the baby is going to come out from. We call it PLACENTA PRAEVIA!
So having said this, I’m sure you all now know what placenta praevia means. It means that the placenta is lying low in the womb, instead of high on the ceiling.
There are different types of placenta praevia. We categorize them from 1-4. So now you see why antenatal clinic visits are so important.
The problem with placenta praevia is that if it is the serious ones, (major placenta praevia) the woman should never be allowed to deliver from the vagina, else she will bleed to death.

The reason is this: in those serious types of placenta previa, the placenta is blocking the exit canal of the baby
And once the woman attempts to push, the head will compress the placenta and the bleeding is TORRENTIAL.
(See attached pic)
😨😨😨
And if resuscitation is not immediate or adequate, the woman could die.
Also of importance is the fact that, in those serious cases, even the obstetrician should never attempt a vaginal exam on the woman cos his fingers could provoke serious bleeding.

There are a lot of things that are believed to cause placenta praevia, what we call RISK FACTORS. They include:

~ Women who had previous surgeries on the womb, like removal of fibroids
~ Women who had Placenta Previa in the past
~ Smoking
~ Women who had D&C or any form of instruments inside their womb in the past
~ Carrying twins, etc.
But the thing about making a diagnosis of placenta previa is that, if you don’t do a scan at nine months, you may not know. So an obstetric scan is always IMPORTANT. It’s something we pick up with a scan and not blood or urine tests.
But sometimes the diagnosis is easier sometimes cos the woman with PP might initially have small spotting early in the pregnancy. We call it WARNING BLEEDS. So if you ask her, she will tell you that she once spotted while she was like 2-3 months pregnant.
That’s what some people think is menstruation, and that’s why I hate hearing that a woman menstruated while pregnant cos it’s not POSSIBLE.

Bleeding from the vagina while pregnant, while very common, does not mean a woman is menstruating.
And that was what happened to kill my friend. The worst part is that I already made this explanation to her when she was eight months pregnant, but she believed she was a Hebrew woman and must deliver via the vagina.

Placenta previa
See the 4 different grades of low lying placenta. The higher the grade the higher the chances of bleeding

How many times have I told you guys that the Hebrew women safe delivery as described in the Bible was a lie by the Egyptian midwives, for which God even blessed them?
This was why my friend refused CS and met her own traditional birth attendants that didn’t see a scan and tried to deliver her from the vagina.
And she bled to death.

Please don’t be so stupid as to neglect the advice of your doctor cos you believe God to do it differently cos God is the Ultimate Healer and the Father of Doctors. He can’t be mocked.

He has already given the human doctors the knowledge to make things easier for you so you don’t have to disturb Him with some basic health issues. But never tempt yourself and say you are a child of God.
It’s plain stupidity.
So if you have a friend or relative who is newly married, pregnant or not, let them know about the importance of antenatal care. It is extremely important.
To play with it, is to to play tunbom tunbom with your life.
I’m really pained.
Akwa na-aguzi m 😢 😢
#Listen_To_Your_Doctors

Placenta previa story can be positive if you listen to your doctors.

There are stories of pregnant women with placenta previa who have had natural birth. It depends on the grade and your doctors MUST make that decision.

It is not funny going into labour with labour with placenta previa.  Let your doctors guide you.

Source:

~ Dr. Caséy Amaefule©

(MBBS, University of Benin)

+++Impossibility is nothing. Just believe+++
#ChukwuGozieUnuNiile

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