Juma D., 18

Doreen is the firstborn in her family and lives with her parents, her son, and her younger sister in a modest two-roomed semi-permanent house. She is a Form Two student and depends on her father, who works as a casual laborer at construction sites whenever opportunities arise. Despite her circumstances, Doreen aspires to become a doctor in the future. At the age of 18, Doreen noticed that she had missed her menstrual periods which were previously regular. Concerned, she shared this with her mother, who encouraged her to seek medical evaluation at a nearby health centre. At the facility, tests confirmed that she was pregnant. Following this, she enrolled in antenatal care (ANC) and began attending clinic visits to monitor her pregnancy. Despite the long distance to the facility, Doreen remained committed and managed to attend four ANC visits, walking for about an hour each time. On the day of the incident, Doreen developed persistent abdominal pain. She initially stayed at home for two days, hoping the pain would resolve on its own. However, when her condition did not improve, she sought care at the nearby health centre. Upon assessment, healthcare providers found that the baby was in distress and required urgent intervention. Due to the facility’s limited capacity to manage such complications, she was immediately referred to Siaya County Referral Hospital for specialized care. At the referral hospital, the medical team prepared her for an emergency caesarean section to ensure the safe delivery of the baby and to prevent further complications for both mother and child.

Doreen was brought to the hospital for an emergency caesarean surgery, which was a success. She was taken to the ward for post op management, her vitals were monitored hourly, her catheter was removed after 8 hours. Early ambulation was encouraged, she was administered IV ceftriaxone, oxytocin, pcm ,plasil among other drugs. Her dressing was removed after 72 hrs. She was eventually discharged on orals and a follow clinic booked for her.

An 18-year-old who undergoes emergency caesarean section secondary to fetal distress with Grade III meconium generally has a good maternal prognosis when timely surgical intervention is performed. However, the condition carries significant risk to the newborn, particularly due to the possibility of meconium aspiration syndrome, respiratory distress, infection, or oxygen deprivation, which can be life-threatening if not promptly managed. Close post-delivery monitoring and supportive neonatal care are therefore critical to improve survival and recovery outcomes for the baby. Prognosis for both Doreen and her baby are good.