We were taking a round of the postnatal ward. I had not known what had happened in the wards during the previous two days because I had been away.
“Sir, this patient was desirous of undergoing a puerperal sterilization operation. She could not undergo the operation because her urinalysis showed 46 pus cells per high power field. We have sent her urine for microbiologic studies” my Registrar said.
“OK” I said. “Let me know the report.”
We moved on. The third patient after that one with pyuria was similar.
“Sir, this patient also wanted a puerperal sterilization operation. She could not undergo the operation because her urinalysis showed 56 pus cells per high power field. We have sent her urine for microbiologic studies too” my Registrar said. The Associate Professor and Assistant Professor in charge of that ward nodded their heads in agreement and with sympathy for the patient.
This was sounding weird. “How may red blood cells were present in their urine?” I asked. They had not thought of checking and hence did not know the answer. The urinalysis reports of the two patients were checked. “That one had 80 red bleed cells per high power field and this one had 76” the registrar said.
I looked at them and they looked back at me, most of them blankly and one with the beginning of comprehension.
“They did not have urinary infection. The urine samples were mixed with early lochia and were inappropriate for testing. If the lochia had been washed away before collecting the samples, they would have been fit to undergo the operation they desired” I said.
The next day the microbiologic reports were ready.
“Sir, there was no growth of any organisms on culture of urine of both of those women” the Registrar informed me.
“Are the two patients ready to undergo the operation now?” I asked.
“Um… one of them had gone home, and the other does not want the operation now” she said.
I have learnt to look at the positive aspects of everything. I applied that principle to this goof-up. “This business proves that the lochia is sterile. That is a scientific achievement” I said. None of the people involved turned a hair. They have probably got used to my sarcasm.
