Polum E., 42

Ms Polum is a 42 yo mother who is currently married to her husband and kids. They live in a small community about 60km away from the city of Bauchi. The family struggles because they are poor. The husband is a labourer and the wife is a house wife. The children hardly go school due to lack of school fees. They live in 3 rooms apartment of which it was inherited, there is a pit toilet, no access to electricity and monthly income is 10000. Polum is a 42 years old pregnant woman at term (past her EDD) with three previous CS and two perinatal fetal death due to birth complications. She has two female children alive. She presented with history of weak uterine contractions of over two days. No other significant problems Examination: Pregnant woman, pale, three different transverse lower abdominal scars. Fetal HR = 120bpm, Diagnosis: Prolonged labour, 3 previous cs and bad obstetric history.

Polum came in with history of multiple previous CS (3), weak contraction for two days and hence not a candidate for augmentation looking at the history of CS and advancing age. The best option is to do CS to avoid risk of uterine rupture which could lead to the death of both mother and child. She was also anaemic with a PCV of 20%, she has also had two stillbirth from previous delivery from late intervention. Thanks to speedy intervention by Helpster and medical team on ground (especially Dr. Perpetua who immediately reviews and grant the request for her treatment), she was operated and delivered of a healthy girl child. At discharge, both the mother and child were doing very well as they responded excellently to treatment. They are encouraged to continue with medications (mother) and to ensure immunizations are given as at when due for the baby. Mother is expected to continue with her follow up visit and to use family planning to avoid future pregnancy as it is going to be more riskier. Mother and baby are fine, family express their sincere appreciation to Helpster Charity and team for the support.

Prolonged labour in a woman with three previous cesarean sections and a bad obstetric history is an extremely high-risk condition requiring urgent specialist obstetric management. Continuous maternal and fetal monitoring is essential because of the danger of uterine rupture, hemorrhage, fetal compromise, and sepsis. Prognosis depends on the speed of intervention and maternal condition. Prompt cesarean delivery improves outcomes, while delayed treatment increases maternal and neonatal morbidity or mortality risks. Thanks to Helpster Charity, Polum had a successful cs, saving her life and that of the baby.