"Bu bayinya cuma sebesar 3 gelas aqua"

 

“Bu bayinya cuma sebesar 3 gelas aqua. Karena belum ada otot nafasnya, jadi nafasnya dibantu mesin ya bu,” kata bapak yassien si dokter anak andalan. A very practical way to describe 750 g. 

Fast rewind to the beginning of a day in my life:

Sakha left home to school. I blogged and posted a new writing, turned out people are actually opened the link! U rock guys. Really appreciate it.

Early policlinic. Finish late. Didn’t have lunch yet. Called my husband to grab lunch outside. He said yes, I bailed. Because of this tiny human being (walaupun terkesan i blamed the universe, sebenernya i felt honored, biasalah perempuan, suka gengsi) :

 

Meet Bayi Ny. A.

She is quite a fighter, and her mom also a fighter. mukanya cuma half of your palm..

Look how long her diagnosis is:

Absent end diastolic pada G4P2A1 hamil 27+6 minggu (USG TM 1), JTHIU, janin IUGR (p<2.5), air ketuban berkurang tanpa ketuban pecah (ICA 6), ibu dengan:

- superimposed preeclampsia with severe feature

- AKI dd acute on CKD (Ur/Cr/eGFR 51/1.5/43)

- asites

- hiperuricemia (9)

- hipoalbuminemia (2.2)

- obesitas grade I (IMT 28 kg/m2 )

- BSC 2x

Basically, she got underlying hypertension way before she got pregnant. Then, because of the presence of the fetus and placenta inside her womb, her vascular started to fail. The vascular in a proper function should be able keep the water and protein inside the vein. But, in this mother unfortunately, water and protein start to leak because of weak vascular wall. This is when the basic become complicated, the kidney, the liver start to fail, the eyes, hand, feet, all swollen like a bee sting but this is not localized swells. we decide to deliver the baby in order to save the mother avoiding further damage.

On the other hand, the baby is not fully mature. We needed her to be taken care of outside her mother womb because her surroundings cannot provide her enough. The baby was oxygen-deprived, she was not able to produce urine (she was thirsty inside). She wasn’t getting bigger her growth retarded. She supposed to be 10 more weeks longer in her moms belly.

The surgery was a some way more difficult, but compared to my own overthinking prediction, Allah gave a lot of ease. The mom was on obat anti pembekuan darah yang seharusnya dihentikan 2 minggu sebelum operasi. Because this was an emergency, who the heck would know to stop the drugs 2 weeks prior? So I expect its gonna a bloody c section. And because the water and protein leak had been so massive, we could see a fluid collection in her abdomen from ultrasound (which is no free flowing water should be in between abdominal organs). So this surgery was like a flood and bloody.

When we cut open the belly, we aspirate 1500-2000 cc free flow ascites. The womb so small, we need to resist the guts from going in our way. She got 2 previous caesarean section before, this means a bit more challenging compared to mothers with no previous history of belly surgery.

The placenta was in the anterior wall of the womb. This means I need to damage the placenta to reach the baby. Placenta is a thing you need to avoid in order to save blood. But in this case I need to parkour, jump n go straight to the baby, I cannot walk in the proper street. I need to jump right into the placenta which covered the entire anterior uterus. Kalo mau ke posterior/dinding belakang rahim itu lebih nyari kerjaan. Karena simply ototnya lebih tebel, susah ditembus.

We took the feet out first, then hips, torso, the hands, and yang paling susah kepalanya. The head was so fragile. Enyoy like pushing a plastic of gelas aqua. I felt like am I gonna break this fragile neck. The temporal bone is so like tulang muda yang direbus kelamaan.

Once the cut the umbilical cord, I handed the baby to the pediatrician, praying, nangis pls nangis. And she did. A very weak cry. But still. Huff. I didn’t kill the baby nor break the neck ehehe. Sebenernya the bone of a newborn still very mobile and flexible. It is hard to break a baby neck even thou we twist the wrong way, as long as you didn’t put power/pivoting the neck.

And mas yassien, the pediatrician, who deserves a post in my blog actually, said that the baby was small like 3 gelas aqua. I hope she will survive, although its very thin for 750 g baby. The baby was taken care in the baby intensive care with all sophisticated machines. And mom also went to intensive care but she is stable and no need sophisticated breathing support. I hope all is well.

I went from hospital to my rumah sakit pengkolan. And called my husband, can we have super late lunch to our favorite sate maranggi place. then we called it a day.