Sheila C., 20

Sheila, a 20-year-old from a humble background, lives with her grandmother and three siblings after her parents separated. Her grandmother is sickly. She works as a tailor, earning between KSh 1,500–4,000 depending on the season, which is barely enough to support her grandmother’s treatment, pay school fees for her siblings, and cover basic needs. At times, the family goes without food. She dropped out of school after becoming pregnant and later trained as a tailor. They live in a two-room mud house with a leaking roof and fetch water from a stream 20 minutes away. At 42 weeks of pregnancy, Sheila presented with abdominal pain, headache, and severe back pain unrelieved by analgesics. Examination showed she was 6 cm dilated with no progress. She was diagnosed with cephalopelvic disproportion, a condition where the baby’s head cannot pass through the mother’s pelvis, making vaginal delivery unsafe. An emergency caesarean section was the only safe option.

Sheila presented to the facility with abdominal pain and severe intermittent headaches radiating to the back, which had been increasing in frequency and intensity and were not relieved by analgesics. On examination, she was diagnosed with cephalopelvic disproportion with fetal distress, a condition requiring an emergency caesarean section as the safest way to save both mother and baby. The surgery was successful, and both mother and child were stable afterward. Sheila received IV ceftriaxone, IV metronidazole (Flagyl), IV normal saline, IV 5% dextrose, and other supportive medications. She responded well to treatment, made a full recovery, and was discharged home in stable condition.

Cephalopelvic disproportion with fetal distress is an emergency cases that requires immediate intervention, it's because of swift ceaserian section that were contacted immediately,we had the best outcome ,if on late intervention it could have been resulted to complications such as birth injuries for the baby (like nerve damage, cerebral palsy, or fractures from shoulder dystocia) and complications for the mother, such as uterine rupture, excessive bleeding.