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An Ounce of Prevention

Updated: Feb 17, 2019

We all thrill to the drama of rescue, be it a rescue of stranded and injured mountaineers, the Coast Guard coming to the aid of a sinking boat, or even a dramatic, life-saving surgery. But while these situations can hold us spellbound, riveted to the TV screen, by and large we would prefer that the climbers simply make an uneventful ascent, that the boats all stay afloat, and that no surgery would be necessary. This month Dr. Laura Bishop’s recent OB-GYN team invested 10 days in Hanoi and Hue, giving instruction and training in how to avoid the dramatic, or, when unavoidable, how to deal with it.

Having a baby must be the most natural thing in the world. As the world’s population is currently estimated at 7.3 billion people, something is clearly working. As someone once put it, we all come from a long line of fertile women!

Except it doesn’t always go right. As in any and every other part of life, things can, and sometimes do, go wrong. Dr. Laura and her team, including Camille (Mary) Fishel and Gina Horne, and Laura’s daughter Brittany, arrived in Hanoi on March 10 with the intention of improving health care in the area of OBGYN (Obstetrics and Gynecology). This was Laura’s 5th trip to Vietnam; Mary and Gina, who both work in Nurse Education and Management in Baptist Memorial Hospital for Women and Children in Memphis, Tennessee, came to serve in Vietnam for their first time.

In Hanoi Laura and her team worked in Vinmec Hospital and in Phu San Hospital, where she has dear friends made on previous trips. In Hue the team worked in Hue Central Hospital and in Hue University of Medicine and Pharmacy, also long-time friends of Laura and REI.

The top two causes of death in pregnancy are post-partum hemorrhage and preeclampsia. Laura and her team therefore addressed both of those issues. When post-partum hemorrhage occurs, when there is serious bleeding after childbirth, the lost blood needs to be replaced. This can be more safely done if you know just how much blood has been lost, so that you can replace the right amount. So the team gave practical training on how to quantify blood loss.

Dr. Laura also lectured on preeclampsia. If you are a fan of the TV series Downton Abbey, you will remember that (SPOILER ALERT) one of the Crawley family members died due to preeclampsia shortly after giving birth. (For those of us who need a primer, preeclampsia is marked by worsening blood pressure and a high level of protein in the urine; women who suffer from this often also have swelling in the feet, legs, and hands. If undiagnosed, preeclampsia can lead to eclampsia, a serious condition that can put the mother and her baby at risk, and in rare cases, cause death.) There's no cure for preeclampsia except for delivery, but by knowing the symptoms of preeclampsia and by seeing one’s doctor for regular prenatal care, risks are reduced. Catching preeclampsia early may lessen potential long-term effects for both mother and baby. One of the applications Laura shared on this subject is that we now know that giving baby aspirin at the beginning of pregnancy for those at high risk of developing the disease can decrease the chance of that development. As part of her lecture, Laura also gave updates on new definitions/treatment as outlined in ACOG/US guidelines.

Laura also lectured on ectopic pregnancy, and the team also presented on recognizing and understanding physiological changes during pregnancy. In addition, Mary and Gina introduced SBAR, an acronym for Situation, Background, Assessment, and Recommendation, which is a technique that can be used to facilitate prompt and appropriate communication between doctors and nurses. This communication model, which has recently gained popularity in healthcare settings, was new to our Vietnamese friends and colleagues, and warmly received.

Brittany also made her contribution, working with the English Club at Hue University of Medicine and Pharmacy and also with the English Club at Hanoi’s ENT Hospital as our AEPE (American English Pronunciation Expert). This was a celebratory trip of sorts for her, as she will be graduating from high school this spring, and then launch her university years as a cadet at the United States Air Force Academy—a real accomplishment, and REI would like to extend its hearty congratulations to Brittany. She is hoping that she can take a gap year two or three years down the road, and invest it in Vietnam!

Over the past several years Dr. Laura has sponsored three different medical professionals as J-1 Fellows through REI, along with friend and long-time REI volunteer Dr. Mickey Smith. During this trip Laura identified Fellow #4, and if all goes according to plan, this person will come to the USA in the summer of 2019 to receive extensive training in OBGYN. Great news for us, for our Vietnamese doctor friend, and for Vietnam!

So lots of good things happened before this year’s OBGYN team flew out of Hanoi late on March 20. Thank you, Dr. Laura, Mary, Gina and Brittany! Thank you, our dear Vietnamese friends and colleagues! Thank you, Mme. Lien and your office staff, for all of your work in preparing for and accompanying the team!

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