Without consent Post Pregnancy Hysterectomy after Emergency Caesarean from England

(Semi Total Abdominal Hysterectomy)

This was my second pregnancy, everything seemed normal apart from ongoing morning sickness and diaphragm pains.

My EDD was 1 st of September 2003. On the 4 th July 2003 I had a scan to check my placenta due to my 20 week scan showing a low line placenta. My baby was in breech presentation at this scan date, however no other checks continued to ensure the baby had turned. On the 8 th of August 2003 it is recorded in my notes that I had a mucus show.

A stretch and sweep was attempted but not achieved. On The 12/09/04 a repeated stretch and sweep is recorded in my notes and this was achieved.

I was booked into the Hospital 1 for an induction for the 15/09/03; however the first stages of labour presented on the 14/09/03.

My contractions where 2 mins apart on arrival to Hospital 2 at 18.30 (This hospital is a low risk unit).

At 20.40 after being told that I was about to deliver the midwife performed a VE, I was 9 and a half centimetres dilated and it was then discovered my baby was in breech presentation. An anaesthetist was called and at 20.50 I was fully dilated.

It was debated whether or not I would make a 20 mile journey to Hospital 1 to deliver and at this point I was asked if I would make the journey for an emergency caesarean as I was told the baby would not be delivered naturally. I agreed and we arrived at Hospital 1 after an ambulance ride that seemed to be forever and thoroughly traumatic at 21.55.

At 22.05 I was transferred to theatre for emergency caesarean. At this point I had to have a blood transfusion of 4 units, and a tear was found on my abdomen wall.

My baby was delivered at 23.45 healthy.

My abdomen was then closed and I was moved to a recovery room at 02.05.

It was then discovered my condition was deteriorating rapidly due to unknown blood loss.

My temperature dropped, BP became unstable at which point I was delusional.

I was quickly transferred back to theatre. On transfer I lost a large clot of blood at 02.30 my heart was complex tachycardia, the crash team called and I received a shock to the heart. It was then discovered in surgery that I had atonic uterus, a constant uterine massage then proceeded, at this point 10 units of blood had been transfused. At 04.00 I was prepped for abdominal hysterectomy which was completed by 06.15. It is recorded that I had lost 9457 mls of bloods and an unmeasured loss on sheets.

I was then transferred to the Hospital 3 where they performed an embolisation to 2 main arteries in the pelvic cavity. At this point a total of 40 units of blood had been transfused. My partner tells me the first time he was able to see me was around 16.00 15/09/03 In ICU where I was kept sedated and ventilated until the 16/09/03.

The decision was made to take me of the ventilator as I was fighting sedation and trying to remove the tube from the ventilator.

At Approx 13.00 on the 16/09/03 I was transferred to HDU. Having been taken off the morphine as my breathing had become shallow. The hospital staff then attempted to perform an epidural. This was not initially successful and they then attempted several times equating to around 3 hours all without pain relief. An invasive mask was used to help with oxygen supply and my arms where held as I was attempting to remove the mask consistently.

At around 19.00 I went into shock. The senior registrar has since told me that when he entered the room I was blue. I suffered from heart failure which led to my lings filling with fluid and subsequently I was put back on the ventilator, sedated and put on medication to drain the fluid and returned to ICU.

On the 18/09/03 I regained consciousness and the ventilator was once again removed.

On the 19/09/03 I was transferred back to Hospital 1 in the HDU recovery room to be with my baby.

My progress went very well and I was allowed home on the 25/09/03 subject to my insistence.

* Jossy's questionnaire

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