LSCS is short for lower segment cesarean section (for those who are not medicos who have not undergone one or have undergone one but don't know what it is called) The list of indications was quite limited about 50 years ago. With advances in maternal-fetal medicine, the list has got quite exhaustive. When we were discussing this issue once, I came to know about some other indications that have not been put down in text books and journals yet.
"Did you know what XXX used to do?" asked someone. "It was a modification of 'failure of induction of labor' as an indication for an LSCS." XXX was a person who worked in our hospital as a unit head, who left for greener pastures some time ago.
"What?"
"Once I saw a patient of that person in the labor ward. She was a staff nurse with a prior LSCS. She was receiving an oxytocin infusion for induction of labor. We both reached the patient simultaneously. I noticed that the oxytocin drip was running like a tap."
"Huh?" I said. "That would cause fetal death or uterine rupture."
"Exactly. I drew attention of XXX to the drip rate. Instead of promptly reducing the drip rate, he/she merely smiled. You know what it means."
"What?"
"There was no oxytocin in the infusion bottle. It was plain 5% dextrose."
"Huh?"
"Yes. The plan was to do an LSCS. But the drip was given to make the patient think that all efforts were made to achieve a vaginal delivery before LSCS was done when induction of labor failed."
"...." I was speechless.
"I heard this was not a one time occurrence. XXX must have made the resident doctors privy to this plan too, since the drip is always prepared, administered and monitored by the resident doctors."
"....: I was still speechless.
"This was subtle" said another person. "ZZZ was more direct." ZZZ was another unit head who joined another institute some time back, for many reasons including a greener pasture.
"How?" asked the person who had told the first story.
"He/she would subject all staff nurses registered with that unit to LSCS. It had got so that when anyone asked about the indication for LSCS in any given case, the Associate Professor in the unit would say 'staff nurse'. Of course the patient herself would be told some other reason."
"But why? Why not treat them like any other patients?" I asked.
"Your guess is as good as mine" I was told.
(Note: XXX, ZZZ, and he/she have been used to protect the identity of persons concerned. This note is superfluous anyway, when you read the warning at the bottom of the page, which reads 'All characters except me and all places and incidents described are fictitious and any resemblance to actual persons, places or incidents will be entirely accidental or coincidental.')
"Did you know what XXX used to do?" asked someone. "It was a modification of 'failure of induction of labor' as an indication for an LSCS." XXX was a person who worked in our hospital as a unit head, who left for greener pastures some time ago.
"What?"
"Once I saw a patient of that person in the labor ward. She was a staff nurse with a prior LSCS. She was receiving an oxytocin infusion for induction of labor. We both reached the patient simultaneously. I noticed that the oxytocin drip was running like a tap."
"Huh?" I said. "That would cause fetal death or uterine rupture."
"Exactly. I drew attention of XXX to the drip rate. Instead of promptly reducing the drip rate, he/she merely smiled. You know what it means."
"What?"
"There was no oxytocin in the infusion bottle. It was plain 5% dextrose."
"Huh?"
"Yes. The plan was to do an LSCS. But the drip was given to make the patient think that all efforts were made to achieve a vaginal delivery before LSCS was done when induction of labor failed."
"...." I was speechless.
"I heard this was not a one time occurrence. XXX must have made the resident doctors privy to this plan too, since the drip is always prepared, administered and monitored by the resident doctors."
"....: I was still speechless.
"This was subtle" said another person. "ZZZ was more direct." ZZZ was another unit head who joined another institute some time back, for many reasons including a greener pasture.
"How?" asked the person who had told the first story.
"He/she would subject all staff nurses registered with that unit to LSCS. It had got so that when anyone asked about the indication for LSCS in any given case, the Associate Professor in the unit would say 'staff nurse'. Of course the patient herself would be told some other reason."
"But why? Why not treat them like any other patients?" I asked.
"Your guess is as good as mine" I was told.
(Note: XXX, ZZZ, and he/she have been used to protect the identity of persons concerned. This note is superfluous anyway, when you read the warning at the bottom of the page, which reads 'All characters except me and all places and incidents described are fictitious and any resemblance to actual persons, places or incidents will be entirely accidental or coincidental.')
