No Warning: Induction of Unknown High-Risk Pregnant Patient to a Level II Facility

A GI, P0, 37 week gestation patient was scheduled by the attending physician, for a Cervidil induction. Indication for induction was listed as “multiple bowel surgeries.” Patient’s prenatal record was unremarkable. Risk factors were listed as “multiple bowel surgeries.” A detailed admission history performed by the Labor and Delivery RN revealed 15 abdominal surgeries. Patient was diagnosed with congenital malformation of entire GI tract at the age of 11. Two of the surgeries were for gastric pacemaker placement. Additional surgeries included cholecystectomy, appendectomy, colectomy, mesenteric artery revision, Port-a-cath placement, multiple bowel resections, and lymphadenctomy (5) from left groin. The patient also suffered from chronic anemia, malabsorption, and lymph edema of perineum and left leg. 

Accurate and timely assessments and a multidisciplinary approach with coordination of care ensured a safe vaginal delivery with minimal complications and positive outcomes for both mother and baby in a Level II facility.