Can't read notes from surgery to manually remove placenta - what does this say?

[EMc12345]

Hi,

I recently give birth and after a horrendous forceps delivery, my placenta failed to detach and I was taken to theatre to have a manual removal of my placenta. I am experiencing a lot of trauma surrounding this and I requested my labour notes to see if these would help me. However, I am struggling to read the handwriting of the doctor who performed the manual removal.

I can read the following:

"Cleaned and draped
Manual uterine entry
Uterus XYZ + placental bed detachment
Placenta removed in whole"

Does anyone know what the word is after Uterus on the third line? E.g Uterus 'something' and placental bed detachment? It's driving me crazy trying to work it out.

Hope everyone is able to see the pic I attached ok.

Thanks in advance.

Mobilized

Stabilised

Thanks for your answer! I'm still not 100% sure that's it though. But better than any guesses I've made so far!

It is definitely stabilised.

Yes stabilised.

Yes definitely stabilised.

Thanks everyone! 🙂

It's stabilised.

The rest is "Cavity checked for emptyness + TAUSS (transabdominal ultrasound scan) confirmation.
Uterine massage + IV oxytocin infusion"

It's a very standard op note for a manual removal. Is there something particular you were looking for explanation of?

@SockQueen thanks! I was very unwell during the birth and also afterwards and so I don't remember much of what happened, particularly during my time in theatre. They also noted that a pack was left in my vagina to be removed after 2 hours. Do you know why they would have done that? I assume it is something to do with my blood loss as I had a PPH.

I had to have manual placenta removal too and it was awful. I had an epidural but it wasn't working properly so I could feel everything. Horrible experience.

I also had an epidural that didn't work properly. I kept telling the midwifes that I was in pain and was told to suck it up basically until eventually the anaesthetist took pity on me and made everyone stop until I was given a spinal. Having to go to therapy now as have awful flashbacks and nightmares about my time in theatre. Sorry you had to go through that too. Just know you are not alone in your experience x

In case you’re going for number two, my manual placenta removal was due to a structural abnormality in my uterus, a sort of shelf is how he described it and the placenta stuck to/in it. So I had it stick and need manual removal for my third as well as with my first, but my third was with an obstetrician who explained to me why it was happening. I hope that’s ok to share, I felt so much better when I understood why.

Not the OP but that's interesting to know, thanks. Mine stuck with my first when my placenta was anterior, came out fine with my second where placenta was posterior. Now I'm pregnant with my third and placenta is anterior again so I'm hoping it doesn't get stuck. I've had quite a lot of D&C's but the Dr who removed it the first time never mentioned any structural problem. If it happened again I'd cross my legs until I was properly anaesthetised.

They use vaginal packs for PPH if the tissue is generally "oozy" - so there's nothing they can stitch (or if still oozing after stitching). Just like you might press on a graze to stop it bleeding, they use a pack to put pressure on and allow time to clot. Not a pleasant feeling though!

I am not sure how well the epidural was working, it was pretty painful, but with an experienced obstetrician delivering my baby he just removed it. With my first the midwife thought about it, called for advice, and got told no bloody way which I’m very glad about, and I went off to theater. The recovery from my third was much much easier.

Was that in the delivery room? That was my experience too. The Dr obviously knew what she was doing but my god it was painful. She did say beforehand that it would hurt so maybe it just is painful even with an epidural.

Do you think the easier recovery with your third was influenced by not having to go to theatre for removal? I remember it being very painful but I was quickly cuddling my baby again which was nice.

re. manual removals and epidurals.... the difference between in-the-room and in-theatre MROP is that an epidural in the room is only topped up for analgesia (if the MWs haven't turned it off completely by then) and that may not be dense enough. If the obstetricians feel that the placenta is coming away (or a woman's hosing blood and it needs to come out quickly) then it is sometimes worth trying in the room with 'just' an analgesic epidural, but one of the indications to stop is if a woman experiences severe pain. Epidurals are pretty variable in how densely they work and sometimes a typical 'analgesic' epidural is dense enough, but adding in entonox as well as the epidural sometimes help as well. If they don't think it's going to come away in the room (eg. if they need to have a rummage around in the uterus, which needs to be done in a sterile way) or a woman experiences severe pain, then going to theatre, converting the epidural to anaesthetic strength, which is much more dense, or doing a spinal anaesthetic would be the norm (or a GA if blood loss has been significant) is more normal. HTH.

@Greybeardy thank you so, so much for this explanation. I've never understood why I felt so much pain and this is very enlightening.

It’s 28 years now since I had my daughter, I too had flashbacks from a traumatic experience. I never had any more children, I was completely traumatised.

I was due to have a cystoscopy the other month due to many UTIs, they couldn’t do it due to me having another UTI. But in the time that I was in the changing room waiting I started to panic and all the old feelings were coming back, I wanted to cry. I’m at the same hospital that I gave birth in so that’s not helpful.

The consultant was a man and very ignorant, so I’ve re booked it with a female consultant, hopefully more understanding. I may ask my G.P for a diazepam to calm me down, I’m trying to be rational but it’s freaking me out 🤷‍♀️