Salome N., 18

Salome is a young girl who had to drop out of school while in Form Two due to difficult life circumstances. She comes from a very humble background and is a total orphan. After losing both parents, she moved in with her aunt, who cares for her despite facing significant challenges of her own. They live together in a small single-room house in a remote area and rely on water fetched from a nearby stream. Salome’s aunt, a single mother of three, was abandoned by her husband after a family dispute. To provide for the family, she walks from house to house selling vegetables as a hawker. Unfortunately, the little she earns is barely enough to provide even one meal a day. Despite these hardships, Salome remains hopeful and dreams of returning to school someday to build a better future for herself and her family. Salome was referred to our facility from Phenal Medical Centre, where she had been admitted in the labor ward for two days. Upon arrival at our emergency unit, she complained of severe lower abdominal pain, back pain, dizziness, and an inability to pass urine. She appeared exhausted and distressed. On abdominal examination, the fundal height indicated a term pregnancy, but the uterus was tense and tender. Fetal parts were not easily palpable, contractions were frequent, yet the presenting part remained high and unengaged. The fetal heart rate was 168 beats per minute. A vaginal examination revealed swollen vulva, full cervical dilation, marked caput, and moulding. Her membranes had already ruptured, and the amniotic fluid was foul smelling. The presence of significant caput and moulding indicated obstructed labor, and Salome required an emergency caesarean section.

Salome was referred from a nearby medical centre with complains of severe lower abdominal pain, backache, dizziness, and an inability to pass urine. On Vaginal examination showed a markedly edematous vulva, a fully dilated cervix, caput and moulding, ruptured membranes, and foul-smelling liquor. A diagnosis of obstructed labour secondary to cephalopelvic disproportion (CPD) was made. Given the severity of the obstruction and the associated life-threatening risks—such as infection, uterine rupture, and fetal compromise— An emergency cesarean section was urgently recommended to save both mother and baby. Operation was successful both mother and the baby were in good condition and discharged.

Salome’s prognosis is good following the emergency cesarean section. With successful surgery and stabilization, both she and her baby are expected to recover well. Postoperative care, including pain management, monitoring for infection, wound care, adequate nutrition and rest, will support her gradual recovery.