The first time I treated a ruptured uterus

The baby was awkwardly positioned, its heart rate was low. We had to deliver her right away.
Dr. Tameeka Law Walker
Dr. Tameeka Law Walker

Photograph by Ben Rollins

Dr. Tameeka Law Walker
Maternal and Fetal Medicine, Georgia Perinatal Consultants
In 2005 I was the
most senior resident on call for the weekend at a hospital in Baltimore. We’d had a busy day, and I was finally getting a chance to sit down. Then I received an urgent page from a nurse. They didn’t want to see an intern; they wanted me.

I arrived in the hospital room to find a pregnant woman writhing in pain. She was about 37 weeks along, and the nurses hadn’t been able to find a heartbeat for the baby. I tried to calm her down so I could perform an ultrasound to figure out what was going on. On the screen, I immediately saw something odd. The baby was awkwardly positioned, and its heart rate was super low, 50-something beats per minute compared to the usual 120s to 160s. I realized we had to deliver her right away.

I gathered the surgical team together and got her back to the operating room as quickly as possible; this procedure needed to happen within 10 minutes or less. The patient had undergone two prior C-sections, so we knew the surgery would be a bit difficult because of all the existing scar tissue.

I made a vertical incision down her belly, and then I saw it—the baby. It wasn’t inside the uterus or behind any layers of muscle. Her uterus had ripped apart, and the baby was just right there, floating in her abdomen. I made the incision and saw its face, just like, “Hello.” I was taken aback. We didn’t have to deliver the baby; it just came out.

The pediatrician immediately got to work resuscitating the baby. At the same time, the mother was bleeding a lot internally because her uterus had completely torn open. We were able to stop the bleeding and sew up the uterus, saving it. Both mom and baby made it through just fine, which is pretty incredible. I only know of one other case where this happened, and both the mother and the baby died. As told to Christine Van Dusen

This article originally appeared in our July 2017 issue.

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