Lucy W., 21

Lucy lost her father at a very young age and comes from a family of seven children, where she is the fifth born. Following her father’s death, the family’s circumstances deteriorated significantly. Due to financial hardship, Lucy was forced to drop out of school while in Class Eight, as her mother could no longer afford to support her education. The children live with their mother in a small one-bedroom house. Their mother works as a house help in a neighbouring household, earning about 100 shillings per day. With this limited income, she is often only able to provide one meal a day for the family, and there are many nights when the children go to bed hungry, uncertain about the next day. Lucy was linked to Helpster Charity after a distress call was received from Mukuyuni Dispensary. She required an urgent caesarean section but was unable to meet the cost. With no other support available, the family found themselves helpless and fearful during a critical moment. Lucy was received at the emergency unit as a referral from Mukuyuni Dispensary, where she had been in labour for approximately two days. She presented with reduced fetal movements and vaginal bleeding, raising concern for fetal compromise. On arrival, she was in poor general condition—visibly distressed, sweating excessively, and clinically dehydrated with dry lips. Abdominal examination revealed a term-sized uterus with a tense abdomen. The fetal lie was longitudinal, but the presenting part was not engaged, indicating poor progress despite prolonged labour. Doppler assessment showed an irregular fetal heart rate with recurrent decelerations following contractions, consistent with fetal distress. Pelvic examination demonstrated an oedematous cervix dilated to 8 cm, ruptured membranes, and grade II meconium-stained liquor, further confirming fetal compromise. In view of the prolonged labour, reduced fetal movements, abnormal fetal heart rate patterns, presence of meconium-stained liquor, and lack of labour progress, a diagnosis of acute fetal distress was made. The mother was promptly resuscitated with intravenous fluids as she was prepared for an emergency caesarean section.

Lucy was a referral from Mukuyuni dispensary after she had been admitted in labour for two days,She presented with reduced fetal movements and per vaginal bleeding, raising concern for fetal complications. On examination she was 8cm cervical dilation with prolonged labour, reduced fetal movements, abnormal fetal heart rate patterns, meconium-stained liquor, and lack of progress, a diagnosis of acute fetal distress was made. Given the high risk of adverse fetal outcome with continued labour, immediate intervention was warranted. Ceaserian section was recommended as the safest method to save lives of the mother and child.

Following prompt recognition of fetal distress and timely emergency caesarean section, both the mother and the neonate should have a good clinical outcome. Post-operatively, the mother is expected to recover well without complications, and the neonate stable after delivery with no immediate or long-term sequelae. With appropriate follow-up and routine postnatal care, both the mother and child are expected to live normal, healthy lives.