Morleen's Pregnancy

A big “Hello!” to all of you back in the U.S.A.

Tyronza and I will be leaving Papua New Guinea and heading your way on Thursday, May 1^st. We have enjoyed our time here, but we look forward to seeing all our friends and experiencing the “comforts of home.”  Tyronza has some big travel plans for us this summer, but as for me, rest and relaxation sounds much better.

I have one final story to tell of a woman by the name of Morleen. I met her the first morning I worked at the Kudjip clinic. On that visit she was 28 weeks pregnant, but looked like she was term with triplets. She was experiencing a lot of pressure and a quick vaginal check showed her to be dilated 1 cm and 75% effaced. The head was also quite low.

Her abdomen was massively distended and on ultrasound revealed a normal 28 week intrauterine pregnancy pushed to the right lower pelvis by a huge multicystic ovarian tumor. You might liken this to a tube of toothpaste slowly squeezing the baby out!

The decision was to operate on the tumor and risk premature delivery or keep her pregnant as long as possible and then operate on the tumor. I reasoned that the tumor was most likely benign and operating at this time would probably trigger labor. She agreed and consented to admission.

We placed her on bed rest, gave her steroids and medicine to keep the contractions quiet and hoped for the best. She really was a model patient. The baby went ahead and grew normally and the mother tolerated the situation, though growing ever bigger. To my surprise she was still pregnant at 37 weeks, though she could hardly move around and needed to sit up to breathe and keep her pulse-ox up.

I decided delivery was in everyone’s best interest. A vaginal check showed her to be 3 centimeters dilated and 100% effaced. A dose of vaginal cytotec set things in motion and she promptly delivered a 6.5 pound baby girl. Morleen lost a total of 11 pounds at delivery, but you could not notice any change in her abdominal size. She did say she could breathe easier.

She was given a week off to enjoy the baby and then asked to return for surgery to remove the tumor.

In surgery, she was found to have an 18.5kg left ovarian mucinous tumor. For those of you from the US, that is more than 40 pounds! I was able to salvage the right ovary, which thankfully looked normal.

Her recovery went fairly smooth and I am expecting to see her back before we return home. At discharge her abdomen still looked pretty big with post-op gas, but I expect her to be much skinnier soon. She should be able to have her next child without all the fanfare.

See you soon,

Dr. P

p.s. Just saw Morleen in the clinic. Both mother and baby are doing well. Her abdomen still sags a lot. She tells me she is going to start leg lifts and sit ups once her 6 week recovery is over.