RESIDENT DUTY REPORT

1. NIGHT DUTY 29-30th SEPT 2023
Dr RUSAGURA Eric
Dr MUTABAZI Viateur
Dr HATEGEKIMANA J.Claude
SUP: Dr David

2. 29YO G2P0010 at 39W5D by Early U/S admitted due to PROM ID:0488567
CC: Gush of fluids
HPI: Started for 2 hours prior to admission
with spontaneous gush of fluid which
motivated her to consult our setting for
management.
ROS: FM+ , she denied any trauma; no PV
bleeding; no dysuria, and no headache
ATCD: G2P0010 . LMP : Unknown
She did 8ANC
Iron supplements given
• TORCH screening –
• No surgical Hx
• No known chronic disease. No known
allergies
O/E: Stable; full awake;
BP 102/61 , HR: 98, RR: 20, T:36,1 SPO2: 97%
CNS: Fully awake, GCS:15/15
RS: No RD , clear lungs.
CVS: warm extremities, S1&S2 are audible; No added
sounds
ABD: Gravid Uterus, SFH:32cm,no palpable UC;
FHR:136bpm
GUS: wet and clean vulva; Pooling test: positive
No vaginal bleeding; cervix closed, not effaced, midposition,
midconsistent, station-3 BS=2/13
MSK: no edema, no deformity; the extremities are warm
U/S : SIUP, cephalic presentation , FHR=132, Antero-fundic
placenta, MVP=1.6cm, EFW=3.1kg
Labs:
Hb:11.5
Plt:234
Glycemia:3.4
HIV:negative
HBsAg: neg
HcV;neg
BG:O positive
FP: IMPLANON
ASS: 29YO G2P0010 at 39W5D by Early
U/S admitted due to PROM
Plan: Admit the patient in labor
-NST, If reactive Induction by cytotec 50ucg 4hrly PO
- Monitoring CTG
Evolution:
She delivered by
SVD, and
discharged

3. 18YO G1P0 at 39W1D by dates admitted in latent phase of labor on term pregnancy ID:701601
CC: Lumbopelvic pain
HPI: started 6hours prior to admission with
lumbopelvic pain like contractions progressively
augmented in frequency; intensity and duration which
motivated her to consult our setting for management.
ROS: FM+ ,no gush of fluids. ,no PV bleeding
ATCD:
G1P0. LMP: 28/12/2022 EDD: 27/09/2023
3ANC: at Private Clinic; All were uneventful
• Iron supplements given;
• TORCH screening neg
• ATV: 2X HIV test: negative
• No surgical Hx;
• No known chronic disease.
• No known allergies
O/E: Stable
BP 12/70 , HR: 92, RR: 18, T:36,3 SPO2:
97%;RR:20
CNS: Fully awake, GCS:15/15
RS: No RD , clear lungs.
CVS: warm extremities, S1&S2 are audible; No
added sounds
ABD: Gravid Uterus, SFH: 35cm, 3UC/10//40’’
FHR140
GUS: Vulva wet; cervix soft anterior, effaced at
100%, dilated at 9cm; station:+1, membrane
ruptured,
MSK: No edema, no deformity
U/S : SIUP, cephalic presentation , FHR: 159Bpm,
antero-fundic placenta, SDP:5,1cm, EFW 3.2kg.
Labs:
Hb:12.3
Plt:232
Glycemia:4,6
HIV:neg
HBsAg: pend
HcV; NEG
FP: Jadelle
ASS:
28YO G1P0 at 38W6D by dates admitted in latent
phase of labor on term pregnancy
Plan: Admit the patient in labor
- Monitoring labor progress
Evolution:
Delivered by
SVD and
discharged

4. 32YO G2P0010 at 37W5D by date with features of PROM on early term pregnancy admitted for IOL ID: 626325
CC: Vaginal gush of fluids
HPI: started 1hour prior to admission with vaginal
leakage of clear fluids without abdominal pain no
fever; no dysuria; no trauma; FM+
ROS: no lombo pelvic pain ,no PV bleeding; no
dysuria, no headache; FM+,
ATCD: G2P0010
G1: aborted at 2 months in 2021
LMP:11/10/2022 GA;37Wks 5days
3ANC : 3 in HC
• TORCH screening ,no HIV,ORh-
• No surgical Hx
• No known chronic disease. No known allergies
O/E: Stable
BP 113/83 , HR: 92, RR: 18, T:36,3 SPO2:
97%;RR:20
CNS: Fully awake, GCS:15/15
RS: No RD , clear lungs.
CVS: warm extremities, S1&S2 are audible; No
added sounds
ABD: Gravid Uterus, SFH: 34cm, no palpable
uterine contractions; FHR 143
GUS: wet vulva; pooling test+;No vaginal
bleeding; cervix: dilated at 1cm
MSK: No edema, no deformity
U/S : SIUP, cephalic presentation , EGA 37W2D,
MVP:7.36cm, EFW 3.07kg, Antero-fundic
placenta, FHR: 143 Bpm; BPP:8/8
Labs:
Hb:
Plt:
Glycemia:
HIV:
HBsAg:
HcV;
BG:
FP: Not yet
decided
ASS:32YO G2P0010 at 37W5D by date with features
of PROM on early term pregnancy admitted for IOL
Plan: Admit the patient
- NST/30min, if reactive induction by Cytotec
50mcg po 4hrly Max:6 doses
- continuous CTG monitoring
Evolution:
28YO G4P1021 at 38W5D by early U/S admitted in latent phase of labor on 1x uterine scar &Denial TOLAC
CC: Lumbopelvic pain
HPI: Started 8hours prior to admission with
lumbopelvic pain like contractions progressively
augmented in frequency; intensity and duration which
motivated her to consult our setting for management.
ROS: FM+ , no gush of fluids. ,no PV bleeding; no
dysuria, no headache,
ATCD: G4P1021.
G1 2020 C/S for breech presentation F 3,8KG
G2: Abortion at 14weeks
G3: Ectopic pregnancy in 2022
LMP: unknown
ANC 6x: 6x at DH, 2X at CHUK all uneventfully
• Iron supplements given
• TORCH screening – HIV test: negative BG:O+
• No known chronic disease.
O/E: Stable
BP 12/70 , HR: 92, RR: 18, T:36,3 SPO2: 97%;
CNS: Fully awake, GCS:15/15
RS: No RD , clear lungs.
CVS: warm extremities, S1&S2 are audible; No
added sounds
ABD: Gravid Uterus, SFH: 34cm, 2 palpable
UC/10 min; lasting fo 25-30 sec. FHR 147
GUS: Clean vulva; cervix firm posterior, effaced
at 40%, dilated at 4cm; station:-3, membrane intact
Bishop score :5/13
MSK: No edema, no deformity; the extremities are
warm
U/S : SIUP, cephalic presentation , Antero-fundic
placenta , FHR: 147 , EGA 38W2D, EFW 3.2kg
SDP:5cm,
Labs:
Hb:12.6
Plt:314
Glycemia:4.2
HIV:neg
HBsAg:
HcV;neg
BG:O rh+
FP: IUD
ASS:28YO G4P1021 at 38W5D by early U/S admitted
in latent phase of labor on 1x uterine scar and denial of
tolac
Plan: Admit the patient
- Do lab investigations,
- Do sign consent form for C/S
Evolution:
She delivered by
C/S male
baby,3.4kg
APGAR :9-10

5. saturdayDay duty
Dr. Leon SEWUMUNTU
Dr. Gustave HABUMUGISHA
Dr. Elias MASENGESHO
Sup: Dr Malachie

6. 31 YO G2P1001 with unknown LMP admitted with features of acute abdomen on suspected ruptured ectopic pregnancy V.S twisted
ovarian cyst
CC: Lower abdominal pain,
HPI: the symptoms started around 8 hours prior our
admission with sudden onset of acute lower abd pain
followed by vaginal spotting which prompted her to
consult private clinic where they suspected ectopic
pregnancy and referred her in our setting for better
management
ROS: no dizziness, no p.v blood clots passage, no fever, no
dysuria
ATCDs:
• G2P1001 G1;SVD 3,5KG in 2019
• LMP unknown
• BG&Rh: O rh + ,HIV;neg
• No chronic disease
• No surgical hx / No allergies
O/E: general status altered by severe
pain
BP:116/87, HR:88, RR:20, T:36.5,
SPO2: 98%
CNS: GCS 15/15,
RS:clear lungs.
CVS: S1S2 Well audible,no added
sounds
ABD: non distended,soft , hypogastric
tenderness with rebound tenderness+
GUS: cervical motion tenderness+
MSK: no LL edema
U/S :empty uterus, parauterine cystic
mass 6x5cm, and minimal free fluid in
douglas (3x3.5cm)
Labs:
Hb:12.5
Plt: 230
BG: O+
Preg:positive
B-HCG:2105
HIV: Neg
Hep B:NEG
Hep C: NEG
FP: Not yet decided
ASS: 31 YO G2P1001 with unknown LMP admitted with
features of acute abdomen on suspected ruptured ectopic
pregnancy V.S twisted ovarian cyst
Plan:
- Admitted the patient
- Do emergency Explorative
laparotomy with possible USO
Evolution: intra op:L-ruptured ectopic
preg, with R-ovarian cyst(not twisted)---
we did left salpingectomy and right
cystectomy-aspirated 100c.c of blood

7. 29Y G2P1001 @39W3D by date ADMITTED WITH PEC+ SEVERE FEATURES ID;250618
CC: Headache, epigastric pain
HPI: the symptoms started 1 day ago with headache
and abdominal pain not relieved by paracetamol then
she decided to consult our setting
ROS :she denied any blurry vision, or convulsion, and
no pv bleeding , FM+
ATCD:
G2P1001 . LMP; consistent with 39wk3d
G1:uneventful svd-in 2020,B.W:3.7kg
4xANC , DH and HC:uneventful
• Iron supplements given
• Treated LL cellulitis 2 weeks ago
• BG O rhesus positive
• HIV negative TORCH screening –
• No chronic disease. No surgical hx
O/E: Stable, Obese BMI;38
BP 162/104 ,HR: 99, RR: 18, T:36,7 SPO2: 97%
CNS: Fully awake, GCS:15/15
RS: No RD , clear lungs.
CVS: S1&S2 audible; No added sounds
ABD: Gravid Uterus, SFH:35cm,no palpable
UC,FHR;136bpm,cephalic pres
GUS: closed cervix, middle ,firm, bishop score 1/13
MSK: mild LL edema, clean healing wound on left
leg,no signs of DVT
U/S :SIUP, cephalic ,CA+, FHR:136bpm, SDP;4.5cm
, EFW 3.9 Kg, Antero-fundic placenta, BPP;8/8
Normal umbilical Doppler's
Labs:
Hb:11.3
Plt:290
Glycemia: 4.2
HIV:NEG
HBsAg: NEG
HcV; NEG
BG: O+
AST;10
ALT:8.7
Urea:2.5 creat :55
FP: IUD Interval
ASS: 29Y G2P1001 @39w3d by date admitted with
PEC+severe features
Plan: Admit the patient and stabilized by
-ivMgso4 Loading 4g then maintenance 1g/h
-Nifedipine tab 40mg BD
-PCT 1g TDS,
-start IOL with cytotec 50mcg PO 4hrly –if reactive
NST
-Monitoring Fetomaternal status closely
Evolution: she deliverd by
svd-good outcome
-B.W;4KG,APGAR;9-10