Age: 31.0
Sex: F
Vaccine: COVID19-2
Symptoms: Endometrial ablation, Epidural injection, Exposure during pregnancy, Foetal heart rate abnormal, Foetal heart rate deceleration abnormality
Clinical narrative: COVID + 12/03/2022.  Vaccination Status - pfizer x2 + Pfizer BIVALENT OBGYN - Dr. DELIVERY TYPE: C-Section    ESTIMATED DUE DATE: Estimated Date of Delivery: 11/28/22 GESTATIONAL AGE AT DELIVERY: 40w5d  G1P1001 DELIVERY PROVIDER:   ASSISTING PROVIDER(S):    FINDINGS: NEWBORN STATUS: Living  NEWBORN SEX:  boy      Delivery Date/Time:   WEIGHT: 3.685 kg  APGAR:  1 minutes - 6 / 5 minutes - 8 /10 minutes       RESCUSITATION: Suctioning;Continuous positive airway pressure (CPAP);Tactile stimulation  PLACENTA REMOVAL: Manual Removal  CORD VESSELS: 3 Vessels  ANALGESIA METHOD: Epidural;General    BRIEF OVERVIEW: Admission Date: 12/2/2022 Discharge Date: 12/5/2022   Active Hospital Problems   Diagnosis Date Noted POA ? Encounter for induction of labor   DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Encounter for induction of labor [Z34.90] Status post cesarean delivery [Z98.891] INTRAPARTUM COMPLICATIONS: Medical Problems (from 12/02/22 to present)    No problems associated with this episode. PROCEDURES PERFORMED: CESAREAN SECTION, N/A - Abdomen HOSPITAL COURSE: The patient is a 31 y.o. G1P0 at 40w5d who presented to L&D for induction of labor due to nonreactive NST in the office.  Her pregnancy was uncomplicated.  Her labor course included cytotec and pitocin.  During her labor course she was noted to have a single elevated temp of 38.0, subjective chills/sweats, and intermittent fetal tachycardia to 160s-170s - a film array was collected which revealed COVID infection.  She got an epidural for pain control.  She had recurrent variable decelerations after spontaneous rupture of membranes with meconium stained amniotic fluid, followed by an eventual prolonged deceleration that did not return to baseline despite resuscitative measures.   The decision was made to proceed with a cesarean section due to fetal bradycardia remote from delivery. She underwent a cesarean delivery complicated by intrapartum hemorrhage and need for general anesthesia. She was treated with TXA, uterotonics, and bakri balloon and recovered well. She met all postpartum milestones and was discharged home in stable condition Delivery Note:  PROCEDURE DETAILS: PRE-OP DIAGNOSIS:   - Intrauterine pregnancy at 40 weeks gestation - Induction of labor for non-reactive NST - COVID + status - Category III fetal heart tracing POST-OP DIAGNOSIS:   - Intrauterine pregnancy at 40w5d weeks gestation, delivered - Postpartum hemorrhage due to uterine atony - Bakri balloon in place with 300cc sterile saline PROCEDURE PERFORMED: CESAREAN SECTION, N/A - Abdomen Delivery Provider:   Other personnel:   ANESTHESIA: Epidural, General TISSUES REMOVED: Placenta SPECIMENS FOR PATHOLOGY:yes CONDITION: Good INDICATIONS: The patient is a 31 y.o. G1P0 at 40w5d who presented to L&D for induction of labor due to nonreactive NST in the office.  Her pregnancy was uncomplicated.  Her labor course included cytotec and pitocin.  During her labor course she was noted to have a single elevated temp of 38.0, subjective chills/sweats, and intermittent fetal tachycardia to 160s-170s - a film array was collected which revealed COVID infection.  She got an epidural for pain control.  She had recurrent variable decelerations after spontaneous rupture of membranes with meconium stained amniotic fluid, followed by an eventual prolonged deceleration that did not return to baseline despite resuscitative measures.   The decision was made to proceed with a cesarean section due to fetal bradycardia remote from delivery.