**Content could be considered graphic in nature.**
I remember being an OB/GYN Resident working my Triage (OB
ER) shift. A fairly young woman came in that evening complaining of prolonged
vaginal bleeding. I do not remember her name. Her exact age escapes me, perhaps
early twenties, but I will never forget her face nor her story.
When she was taken to the room by the nurse, she was quiet
but concerned. The nurse filled me in on her complaint of vaginal bleeding for
the past 2 days. The patient told the nurse that she was confident that this
was not her period, but offered no other information. I went in to see this young woman and noticed
that she was pretty quiet, guarded, and concerned. She also appeared unwell; slightly flushed but
pale. I spent some time speaking with her about what was wrong and why she came
in that day. She repeated her
explanation of bleeding and some pelvic pain. She offered no other history. We then agreed on an exam.
During her examination, I found a large amount of very dark
and clotted blood. Most notably, her exam exhibited signs of trauma. Upon conclusion of the exam, I questioned her
further. She then disclosed that she was pregnant – she believed early in her second trimester – but had an abortion 2 days prior. She did have some bleeding afterwards which concerned her, but the provider and “nurse” told her it was fine and to call back if she had further concerns.
She stated that her bleeding became much heavier and she
began to have pelvic cramping and cold sweats. She returned to that office the
following day but was turned away. She was told that there was nothing that
could be done for her there. They recommended that she seek medical attention
in the ER if she became worse. She told
me that she figured that if they weren’t concerned about it, then she would
give it some more time. As she continued
to bleed and have pain, she decided that something was wrong. She told me that
no one close to her knew about her procedure so she came into the hospital by
herself.
Upon further examination and ultrasound, we found that she
had a horrific complication from her procedure – which was likely to have been
a D&E (Dilation and Evacuation). She had some remnants of fetal parts,
still in utero, and lacerations to cervix and upper vagina – likely from
evacuation of the other fetal parts. She had prolonged hemorrhage and infection
that was difficult to repair and reverse. Without quick and wise judgment, her
condition would become quite morbid, if not fatal. We agreed that a
hysterectomy would stop her bleeding, get the infection under control, and
hopefully save her life – which it did.
It pained us to perform a hysterectomy on such a young woman,
but with this complication, that was all we could do. Thank God, she fared well through her recovery. I imagine that
this is just one of many cases of such a tragic, never-ending story. Just as sure as I am that this experience will
never leave her, I also will never forget her.
