The woman who died during child birth this week at the Georgetown Public Hospital was given a pill to induce labour, according to her husband and sources say that the subsequent management of the patient is what investigators will have to look at.
Luan Rodney’s husband, Nigel, says he was told that she had a Cytotec pill inserted into her to bring on labour since she was long past her due date. She was due to deliver by May 22 and the pill was inserted on the night of June 3. She died the following morning at the Georgetown Hospital from what doctors have described as a ruptured uterus. Her baby, a girl, also died.
Cytotec, which has previously raised concerns here over its abuse as an abortion-inducing agent, is also utilised to induce labour in women in the advanced stage of pregnancy. According to medical sources, its use is safe once it is administered by a doctor and the patient is continuously monitored. Cytotec (misoprostol) is mainly used to reduce the risk of gastric ulcers in patients at high risk of complications from such.
Nigel told Stabroek News on Thursday that he was informed that Cytotec was the pill that was inserted into his wife.
Stabroek News attempted to elicit a comment on Thursday from the Georgetown Public Hospital on the use of this pill but was unsuccessful. During a visit to the office of Dr Sheik Amir, the hospital’s Director of Medical Services, this newspaper was told by the secretary that this issue had to be first discussed with Dr. Amir. This newspaper, she said, would be contacted at a later date with respect to an interview.
A midwife told Stabroek News that Cytotec is commonly used to induce labour. She explained if it is a full term pregnancy and there is need for labour to be induced, medication is administered, such as the pill Cytotec.
The midwife, however, warned that once the pill is inserted the expectant mother’s blood pressure and heart rate have to be continuously monitored along with the baby’s heart rate.
In the case of inducing labour, it was explained that it is the doctor who would have had to insert it, usually in a milligramme dosage.
A medical doctor also confirmed that Cytotec is being used to induce labour and she also stressed the need for the patients to be closely monitored.
“Yes they use it to induce labour because it causes the uterus to contract,” the doctor said while noting that in the case of Luan, 28, seemed an issue of her not being monitored adequately since all the warning signs were missed.
The doctor stressed that once a decision is taken to induce labour, the patient must be monitored more closely.
Nigel had told this newspaper that a patient had related to him that his wife lay on her bed in the ward in pain and was given no attention by the nurse. He said that the young lady related to him that she at one point went to the nurse to draw her attention to the situation but was chased back to her bed. Shortly after that, the young woman said that she noticed blood and it was at this point that the nurse sprang into action. After she had died, he said, the doctor told him that the uterus had burst because the baby was too big.
Alarming numbers
According to the US based National Institutes of Health website, the use of Cytotec to induce labour and soften the cervix is an example of an unnecessary intervention that is not supported by research yet is rapidly becoming the standard of care.
According to the website, in August 2000, the original manager of the pill G.D Searle & Co. (Searle) sent a letter to over 200, 000 OB/GYNs in the country stating the possible side effects of Cytotec when given to pregnant women, such as hyperstimulation of the uterus, uterine rupture, foetal bradycardia, amniotic fluid embolism, death of the mother and death of the child.
Stabroek News has been reliably informed that of recent there have been cases of women’s uteruses rupturing during child birth at the Georgetown Hospital but Luan’s case has been the first fatality in recent times.
A medical source said that while the numbers are alarming, nothing is being done to ascertain why this is happening so often and what can be done to prevent recurrences. The source said that this problem highlights the need for a proper forensic investigation to be done and unless this is done “it will happen again and again.”
The source noted that the cases involving the women who survived are as equally important as Luan’s case. The source, while noting that it is unclear if those women’s uteruses were also ruptured as a result of induced labour, said that “it doesn’t matter what triggered it. It is not supposed to happen.”
It was explained that the rupturing can occurred in normal labour and during induced labour.
When the uterus ruptures, the source said “it is a life and death matter because the uterus has a lot of blood supply. You bleed rapidly. You can bleed to death.” The saving of the patient, the source added, depends on the extent of the rupture.
Nigel told this newspaper on Thursday that he met with the doctors who were tending to his wife when she died but they had nothing new to tell him. This newspaper was told that the man was accompanied by two women who are close to him and his wife.
He said that the doctors did not reveal anything different from what they told him hours after his wife died. “They tell me back the same thing they tell me. They tell me that they will get back to me,” he said.
The grieving widower said that when he related what he had been told about how his wife was treated, the doctors said that they were unaware of that and will investigate.
Based on what he had previously related, his wife was admitted to the Georgetown Hospital since her May 22nd due date, based on two ultrasounds, had long passed. She arrived around 8 am on Monday and was never admitted until 3 pm that day. The man said that he remained with his wife through the visiting period (4pm to 5.30 pm) and when he left all was well.
He said that he spoke with her just after 10 pm and she told him that a tablet had been inserted to induce labour. About 2 am the following day, a cousin informed him that she was having a contraction every four minutes.
When he went to the hospital just after 6 am to take breakfast, Nigel said he could not find his wife. When he inquired, he was told that she was in the operating theatre. He said that he was not surprised by this as he thought she had an unusually big belly.
On his way back home from dropping his daughter off to school, Nigel got a telephone call from a doctor, who asked him to visit the hospital concerning his wife. When he arrived at the institution, he was greeted with the news of her death.
Nigel blamed negligence for the death of his wife and baby and said that he wants answers from the hospital. The hospital has since said that an investigating has been launched.
