Thursday, February 25


I was the Co-assistant in charge of today’s second Caesarean Section (CS) in the Emergency Operation Theatre. The CS was operated by Dr Gug and his junior doctor, Dr Las (FYI, dlm department Obs & Gynae ni mmg sume doc ade initials die..dgn 3 huruf such as Las, Gug , Tit etc..smp kadang2 membuatkan saya tidak ingat nama sebenar mereka!! Nk kne igt nama patients lg, seniors lg..haih penat la igt nama org byk2! Tu belum masuk nama supervisors saya lg*).

What is Caesarean Section? It refers to an operation that is performed to deliver a baby via the transabdominal route. CS is one of the earliest known operations performed. It has been reputed to have gotten its name because Julius Caesar was born by such an operation. How interesting kan!! (nevertheless, ade banyak theory lain tentang asal muasal pembedahan ini tapi saya malas nk ceritakan semuanya kat cni laaa…)

There are basically two kinds of CS. The first and by far the most common is the lower segment CS (LSCS). This involves a transverse incision over the lower segment of the uterus. This LSCS type is more popular because of its better wound healing process than the another type of CS that is the Classical CS (upper segment incision).

Indications for CS :
• Obstructed labour
• Fetal distress
• Maternal medical conditions eg preeclampsia
• Obstetric complications eg placenta previa
• Previous Caesarean Section

[MAK was operated to deliver her two naughty babies Afdzal and Dhuha via the LSCS technique. Cian mak..2 kali kne operate perut..huhu. From mak and bapak’s story, Afdzal was ‘drowned’ (lemas) during delivery process and was rushed for emergency CS or in medical term my little brother was having ‘fetal distress’. Whilst little Dhuha was in transverse lie (melintang) even after the doctors did several external versions but still failed. *Haih dua baby nakalsss!! Kecik2 lg dh nakal! Kakak and abang senang jer keluar, senang keja mak ;p*]

Now back to my patient’s story. Ny Tuminah was married for 11 months and now expecting her first child. She was admitted to the hospital due to high blood pressure, last measurement taken was 170/100 mmHg. So the doctors decided to terminate her pregnancy with CS in conjunction to the evidence of pre eclampsia.

I entered the operating room and got myself ready on scrubs while the anesthetic team doctors started their sedative jobs. Then the nurse inside helped me with the hand gloves, plastic shield and masks. Once the anesthesia has taken effect, an abdominal cut was made by Dr Gug, and an opening is made in the uterus. The amniotic sac is then opened (the amniotic fluid aka air ketuban flushed out like a giant leaking pipe!! and the wise me already prepared myself, taking 1 step back from the mother so that the liquor wont ‘wash out’ my face for free!!! Skrg saya dah pandai budget time utk mengelak darah and air ketuban yang memercik sebab dah ade pengalaman terkena sekali ;p),

A baby boy was parturitated, the baby was blue, did not cried (and did no attempt gasping some air into his lungs of course!!). Maybe because too much time was taken to take him out from the womb (I think it was 5-6 minutes till we managed to pull him out). The baby was then passed to the midwife as she ran out from the operating room to quickly resuscitate the quiet baby. Huh, we were having the adrenaline rush running throughout our blood vessels hence the baby was not crying!! But 3 minutes later, we heard the most awaited baby cry. And everyone was sooo relieved! Praise be to Allah, we continued the delivery of placenta (uri) and finally, suturing the mother’s womb layer by layer. I got to learn the REAL woman reproductive system anatomy during the suturing process. And Dr Gug sangatla xlokek ilmu dan banyak mengajar.

I enjoyed assisting today’s operation, although not much that I helped (I only helped Dr Gug with the suction machine that sucks out the blood coming out so that Dr Gug will have a clearer vision to repair the incision part) Ok lupe, I also helped Dr Gug pull out the baby. The baby was quite big and sangat susah nak tarik die keluar. Berpeluh2 doc saye buat keje..hehe. Kesian tgk. But it’s worth the job, worth the 3 hours long standing! And most importantly, I became part of the medical crew who helped a new baby borned, adding another human population into this whole new world! ^^

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