Kate Hardy

The Registrar's Convenient Wife


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That at least won’t let you down.

      All the same, she was smarting again over that near clinch with Eliot, so she was relieved when Tilly called her over to look at one of their newer babies and she could concentrate on work again. ‘Second-born twin, born at thirty-five weeks gestation,’ Tilly said. ‘The symptoms developed about an hour after birth so they’ve sent her up here in case it’s RDS.’ Respiratory distress syndrome was common in premature babies because their lungs hadn’t matured enough yet. ‘Her breathing’s fast, she’s grunting a bit, she’s got nasal flaring and intercostal recession.’

      Claire noted the way the baby’s skin sucked in between and under her ribs. ‘She’s, what, two hours old now?’

      ‘Yes.’

      Claire listened to the baby’s lungs. ‘The air entry’s reduced and I can hear creps.’ She did some more checks. ‘Heart rate 125 a minute, low blood pressure.’ They could both see that the baby was lying in the ‘frog’ position, not moving as much as they’d expect from a newborn. ‘OK. We need the usual bloods—haemoglobin, white-blood count, platelets, gases, blood group and cross-match. Check the electrolytes, creatinine and calcium so we’ve got a baseline; blood culture plus deep ear and throat swabs to rule out any infection; and a chest X-ray to check we don’t have any extra problems.’

      Gently, she stroked the baby’s cheek. ‘Hang on in there, little one. I know it’s tiring, but we’ll soon help you breathe more easily.’ She looked at Tilly. ‘Is the mum downstairs?’

      Tilly nodded. ‘Probably frantic—and panicking in case the other twin has the same problem.’

      ‘I’ll go down and see her,’ Claire said. She rang down to the maternity unit, then went to see Carla Jennings.

      ‘I’m Claire Thurman, senior registrar on the neonatal ward,’ she said. ‘I thought you’d like an update on Gillian.’

      ‘Is she going to be all right?’

      ‘We hope so. We’re doing some tests at the moment, but I’m fairly sure she has what we call RDS—respiratory distress syndrome. It’s fairly common in premature babies, and second-born twins are more likely than the first-born to get it. All it means is that she’s having problems breathing because her lungs aren’t mature enough. We’re going to keep her warm, give her some oxygen to help her breathe and, depending on the test results, some synthetic surfactant to make her lungs mature.’

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