After a long absence, SANA’s team returned back to Btourmaz where nurse Ghinwa, together with a large group of mothers and infants were waiting…

 

The attendees had requested information on all issues pertaining to ‘family planning’ and as such SANA presented all the key medical and health concerns of short-birth intervals, from anemia, to calcium depletion and the inherent risks of osteoporosis, that may affect expectant and nursing mothers.

 

All methods of spacing birth were then discussed and an interactive discussion ensued where SANA attempted to answer all questions and concerns.

 

Subsequently, prenatal care with sonographic assessment was carried out. What was most striking today was having two patients with hypertension and proteinuria, and several with recurrent abortions. As such, proper medical instruction, planning and care were provided, with follow up arranged.

 

All nutritional supplements today were made courtesy of Mr. Dory Mansour.

 

And after a most rewarding day, SANA set the date for the return visit to Btourmaz and headed back home after several pauses along the scenic route in order to capture memorable images of beautiful orange groves…

Amidst grey skies and an impending storm, SANA returned back to the Governmental Hospital of Seer Al Dinnieh for another didactic/hands-on session to re-enforce what was covered last week with the Obstetrical team, and to allow those who were on duty last week to catch up with their peers.

 

After the didactic session, which again concentrated on basic normal fetal anatomy and introduced ISUOG’s guidelines to performing a second trimester fetal scan, a long hands-on session ensued and there was a marked improvement in the level of skill, especially amongst the attendees who were there last week.

 

The IUSOG 6-step approach was carried out ever so smoothly, biometrical measurements and estimated fetal weight were obtained, and the midwives and nurses seemed to be at much more ease handling the probe and operating the sonographic machine. The previously challenging femur length measurement was obtained with a lot more speed today, and recognition of basic fetal anatomy, from the stomach, to the bladder, the 4 chamber heart, the cord insertion, fetal orbits, and in some cases the sagittal fetal spine, were carried out systematically.

 

There were several challenging patients seen today, 2 of whom were in the first trimester. And though SANA has not yet coverevd the constituents of the first trimester scan, the attendees were introduced to measuring the crown rump length as well as thebiparietal diameter on those cases.

 

A plan was set in place for the Obstetrical team to help each other practice their newly-learnt skills between now and SANA’s next visit in February.

 

And though the sky was dark with winds gaining momentum when SANA left, all felt ever so bright, hopeful and proud of the long strides taken by the able team at the Governmental Hospital of Seer Al Dinnieh…

SANA returned back to the Governmental Hospital of Seer Al Dinnieh for another sonographic training session, targeting the midwives and obstetrical nurses, against a backdrop of white mountain tops and hospital grounds that were beautifully sprinkled with the freshest of snow…

 

There were a total of 8 trainees today, and though half of them were post-call, they ever so patiently awaited SANA with bright smiles and much eagerness to further enhance their skills.

 

The day commenced with a didactic session where the focus was on how to carry out a full anatomical survey on the fetus in the second trimester. Normal anatomy was covered in depth,  and the attendees were provided with detailed handouts in addition to ISUOG’s Guidelines on performing an obstetrical scan in the second trimester.

 

After the didactic session, hands-on training ensued with the trainees assisting each other. The biggest challenge, which was overcome today, was to properly capture the femur, the fetus’ thigh bone, in the actively moving fetuses and to measure it correctly.

 

All of the patient seen had healthy beautiful babies, and the patients were so thrilled to have their birth-attendants scan the babies. Our youngest attendee sat in Midwife Loulou’s lap, watching on as Nurse Ibtisam evaluated his sibling…

 

At the end of another successful session, plans were made for the next visit in order to allow the midwives and nurses, who had floor duty today, to catch up with the rest of the team…