Aku dan Statistik

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16 Disember 2010

Aku dan Amniotic Fluid Embolism

Menangani Amniotic Fluid Embolism(AFE) adalah satu pengalaman ngeri yang seboleh2nya cuba dielakkan oleh doktor2 profesional sepertiku. Ianya sangat jarang berlaku, tidak diketahui puncanya dan kematian mengejut adalah dijangkakan. Sepanjang perjalanan kehidupanku sebagai doktor, aku tak pernah menghadapinya. Alhamdulilah.

Diceritakan kepadaku, kes2 AFE memang pelik dan musykil. Pesakit yang telah bersalin normal tanpa apa2 tanda dan petanda tiba2 menjadi sesak nafas, gelisah dan kadang2 terus berhenti bernafas. Tekanan darah turun mendadak dan kadang2 berlaku pendarahan yang banyak. Kebanyakan kes2 AFE berakhir dengan kematian kerana penyakit ini jarang2 berlaku dan sebab2nya masih tidak diketahui.

Dipercayai bahawa faktor usia ibu boleh menjadi penyebab. Dipercayai juga bahawa semasa proses kelahiran, sebahagian tisu bayi berjaya memasuki sistem darah ibu menyebabkan berlaku perubahan mendadak kepada sistem fisiologi ibu seterusnya boleh menyebabkan kematian.

Kematian ibu mengandung adalah menjadi penanda aras negatif kepada sistem kesihatan kebangsaan. Ini bermakna jika ada berlaku kematian ibu semasa mengandung atau bersalin, satu jawatankuasa khas akan ditubuh untuk menyiasat punca2nya. Semua orang termasuk doktor, sister, jururawat dan semua yang ada dalam labour room akan dipanggil untuk memberi kenyataan. Mereka juga kena tulis laporan panjang dan mengisi borang2 yang berhelai2. Pastinya mereka akan disoal bertalu2 sepertimana peguambela Anwar Ibrahim 'mengrill' saksi2 pendakwa dalam kes mahkamahnya.

Ini baru satu. Nak kena menghadap suami dan ahli keluarga si ibu dan memberi jawapan2 kepada persoalan2 mereka lagi susah. Apatahlagi bila suratkhabar dan ahli2 politik turut masuk campur. Semua nak tumpang glamour dan dapat nama. Prihatin kononnya.

Kepada doktor2 di luar sana, belilah insurans kesihatan Medical Protection Society. Biarkan mereka2 yang arif menolong memberi jawapan bagi pihak anda. Bukan senang nak menerangkan sesuatu yang anda sendiri pun tak pasti penyebabnya. Nak tahu berapa harga polisi insurans tahunan untuk pakar2 Gynaecologist?

Anda boleh beli Proton Saga baru FL 1.3 Executive color granite grey harga tunai dengannya.

Protest over death of mum during labour

SARBAN SINGH
newsdesk@thestar.com.my

SEREMBAN: A group of people gathered outside a private specialist hospital here to voice their unhappiness over the death of a woman and her unborn son on Dec 6. The group, led by Seremban Umno division head Datuk Ishak Ismail, alleged that the staff did not follow procedures and the hospital was ill-equipped in proper medical facilities.

Ishak said it was unusual for the 40-year-old woman, Norliza Shariff, who was a mother of four children, all delivered naturally, could die in this case. “I will raise the matter with the Health Ministry,” he said. Norliza’s husband Khairul Anwar Abdul Halim had lodged a police report over her death on Dec 8.

He claimed that his wife and unborn son died as a result of the doctor and nurse’s negligence. The businessman claimed that he had taken his wife to the hospital at about 8.30am on Dec 6, when she showed signs of labour. He had repeatedly requested for the doctor to perform a Caesarian section due to her age. However, he claimed that the doctor had refused to do this. His wife was also put on an oxygen mask for two hours to ease her labour pains. However, at about 5pm, Norliza started to vomit and told her husband that she was not feeling good. Both mother and unborn son died at 6.35pm.

At the hospital yesterday, Khairul Anwar said his wife was bleeding from the ears, mouth, nostrils and eyes when her body was brought out from the room. He said he had also not been able to register his wife’s death with the National Registration Department as the hospital had not certified her burial/death certificate. Khairul also disputed the hospital’s contention that “amniotic fluid embolism” (AFE) was the cause of Norliza’s death.

(AFE is a rare obstetric emergency where amniotic fluid, fetal cells, hair, or other debris enters the maternal circulation which could cause cardiorespiratory collapse).

A representative from the hospital said they have begun a probe into the matter.

“We are not able to say anything now,” he said. “Investigations are underway and we would notify the family of any developments as soon as we can.”


5 ulasan:

  1. Alahaiiiiiiiii..baru 2 minggu lepas saya jumpa Datuk Sahak ni....

    Apa sebenarnya COD?

    BalasPadam
  2. Biasalah....
    Fluid Embolism untuk cover line.
    Yg lain2 hanya mereka2 yang mengetahui.

    BalasPadam
  3. tak suka bila politician start masuk campur

    BalasPadam
  4. very informative..thanks doc..ade jugak rupanya mcm ini..

    mahalnya insuran pakar sakit puan beli!!

    BalasPadam
  5. MAMPUS MAMPUS JE LA, AFASAL NAK SALAHKAN DOKTOR TU. GUNALAH OTAK SIKIT

    BalasPadam