There are always what appear to be strings of similar cases in medicine. They work out to be a great way to learn, then solidify the learning by practicing it over and over again.
Recently, it was the skill of artificially rupturing membranes. This involves inserting a plastic hook through the internal cervical os and tugging at the amniotic sac enough to make a small hole. We always check to make sure that there is a hard head well applied. If not, we could end up with a cord prolapse. A very scary obstetrical emergency.
There was one particularly difficult ARM that I did. The internal os was a fingertip open and very posterior. I really wanted to do a touchdown dance when I got the gush of fluid. But that would have been wrong.
Heaven forbid I be allowed to enjoy being so clever and doing so well with my new skill.
During one of our busiest days, I ruptured membranes for an adorable woman quite easily. Later that night, her clever nurse noticed that labour had slowed down and had a strange contraction pattern. Her doc went in to double check the cervical dilation. According to the patient, he was up to his elbow and making a funny face. She was, to be fair, hopped up on nitrous gas. You can't deny though that her baby was breech. I ruptured the membrane over a bum. The patient was kind to me. She said she was sure baby had flipped since I ruptured the membranes. Sweet white lies.
The new skill I'm working on is applying to gel to cervixes to make them appropriate for induction of labour. But I've learned. All these moms are getting Leopold maneuvers and an ultra sound to make sure junior is head down.
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