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Mrs Staveley nodded.
‘That’s a good sign,’ Madison said, holding her hand. ‘I know you’re worried—it’s only natural after what you’ve been through—but you’re in good hands. Theo’s the best.’
Theo put the head of the transponder unit over Mrs Staveley’s abdomen. ‘One baby. And I can see the baby moving, so try not to worry.’
Maddie, who could also see the screen, mentally counted the baby’s heartbeats and winced inwardly. This wasn’t good. Particularly as nothing else on the scan seemed wrong. Theo’s hunch about a concealed abruption was proving to be right.
Theo removed the transponder and wiped her skin clean. ‘I want to keep an eye on your baby’s heart rate, so I’m going to put a monitor on your tummy. Is that OK?’
She nodded.
He took her hand gently. ‘I think that in the accident your placenta came away from the wall of your womb. We can’t see it on the scan, but your blood pressure’s dropping and your heart’s beating too quickly, so that tells me you have what we call a concealed placental abruption—the blood’s collecting behind the placenta instead of giving nutrients and oxygen to the baby. So what I need to do is give you a blood transfusion and put a catheter in so we can check your urine, then take you up to Theatre and deliver your baby.’
Mrs Staveley grabbed the mask and dragged it away from her mouth and nose. ‘You can’t, it’s too soon!’
‘You’re thirty-four weeks, yes?’
She nodded.
‘Your baby might need a little time in special care to help with breathing, but that’s normal for babies born this early. We deliver babies much earlier than this and they’re absolutely fine, so try not to worry.’
‘Is there someone we can call for you?’ Madison asked.
‘My husband…Except he’s at work.’
‘Give me his number and we’ll call him,’ Madison said.
‘But I’m afraid we can’t wait for him to get here before we deliver the baby,’ Theo warned gently. ‘I might need to give you a Caesarean, in which case you’ll need a general anaesthetic and your husband won’t be able to come into Theatre, but we’ll keep him informed and bring him to see you as soon as possible.’
Madison wrote down Mr Staveley’s number while Theo said quietly to Ed, ‘We need a haematologist, fresh frozen plasma if we can get it or fibrinogen if we can’t. Also a neonatal specialist, plus put the special care baby unit on standby. And we need to stabilise her before we take her to Theatre—are the cross-matched units here yet?’
‘I’m on it,’ Ed said.
‘Maddie, I want you to keep an eye on Mrs Staveley’s blood pressure, urine output and the foetal heartbeat, OK?’
‘Will do.’
Theo talked Mrs Staveley through the procedures, then inserted a catheter before giving her a transfusion.
‘Systolic pressure, Maddie?’
‘Seventy-eight.’
‘Right. We’re looking at at least fifteen hundred mils. Ed, the blood?’
‘Here,’ the registrar said.
‘Great. Keep this going through. Maddie, what can you tell me?’
She gave him the figures, knowing they would mean little to Mrs Staveley but Theo would know the baby was in distress. ‘Systolic’s 100.’
‘Great. We’re there.’ He took Mrs Staveley’s hand. ‘We’re taking you up to Theatre now, and the anaesthetist’s meeting us there,’ he said gently. ‘You’re doing really well. But I’m going to have to deliver the baby by Caesarean section. It means you’re going to be asleep through the operation, but this is the safest thing for you and for the baby.’
Although a vaginal delivery would be better for the mother, the baby was in distress and they didn’t have time to wait—if they left it much longer, Mrs Staveley was likely to develop a clotting disorder, and that could be disastrous. Even though Madison knew just what an emergency this Caesarean section was, Theo maintained an aura of calm and stopped their mum-to-be worrying.
And then the anaesthetist was talking to Mrs Staveley and the theatre nurse was preparing her for the operation while Theo and Madison scrubbed up. ‘We’re going to have to be quick about this,’ Theo said. ‘The baby’s in distress, and we need to keep an eye on Mrs Staveley as well. I need hot packs, and we’re going to have to hope that the bleeding stops with a quick delivery, or we might end up having to give her a hysterectomy.’
They’d worked together in Theatre before, and Maddie knew just how good Theo was. Given his excellent working relationship with the haematology department and Neonatal, she was sure this was going to work out with the right result.
