congratulations!!

tonight i was examining a patient who came to the ER with complaints of low back pain. part of her work-up included a rapid pregnancy test, and the patient was quite suprised to find out that she was with child. i ordered all the usual "oops, i just found out i'm pregnant" labs with a pelvic ultrasound to make sure her pregnancy was in her uterus. while awaiting the ultrasound i performed a pelvic exam to get a look and her cervix, and i was dismayed to see some fluid coming from her uterus which appeared to be a precursor to a miscarriage. i kept a straight face and sent her off to ultrasound. about 30minutes later my ultrasound tech came running up to me,

"doctor, she's gonna have a baby!"

"she's not having a miscarriage?"

"no she's 38 weeks pregnant!"

oops...

i quickly went to the patient's room to share the good news.

"good news! you're gonna have a baby!"

"i know, you told me my pregnancy test was positive."

"no, you're gonna have a baby NOW!"

the patient was stunned to learn that her low back pain was the beginning of labor and she had had no idea that she was even pregnant. unfortunately when you weight 350 pounds an extra 30 can easily go unnoticed, but i would think the abscence of a menstrual period for 9 months would have tripped alarms at some point!

after letting the patient call her husband to share the news, i transferred her to labor and delivery where she could continue birthing her baby that had zero pre-natal care.