Chapter 194: Ergotism (6)

The day of the surgery.

More people than usual were gathered inside the operating room.

Because the surgery of a high-risk mother in childbirth suffering from the Demon Disease was not something commonly seen.

Most of them were people from the Lafavre Sect.

However, there were those in this operating room who did not belong to that sect.

None other than Jenny, Ayla, and Lauren.

There was a reason for calling them.

"...I am telling you this just in case."

In front of the operating room.

I warned the three of them in advance.

"The Patient is a Demon Disease patient. In principle, she is someone on whom Heal must not be cast."

"Then why did you call us..."

"If the bleeding becomes uncontrollable, we might have to cast Heal even at the risk of the Demon Disease worsening. You are the backup for that final moment."

'At that point, I'll just have to risk the Demon Disease and cast Heal.'

'Because I need to stop the bleeding to even hope for what comes next.'

'As for the problem of the immune system going into overdrive afterwards... I'll have to deal with it using Life Magic and Steroid.'

"Saint Lauren. Is your Regeneration ready for today?"

"It is. I have been doing a Fasting Prayer since yesterday for today."

"Good."

I had assigned roles for all three of them.

Ayla with Minor Heal.

Jenny with Greater Heal.

Lauren with Regeneration.

They were a force I had prepared according to each stage.

'I hope there won't be a situation where these people are needed, if possible.'

After firmly preparing even a backup for the backup like that.

We went into the actual surgery.

"Anesthesia has been administered. Vitals are stable."

"Good. I will begin the incision."

The anesthesia took effect, and the disinfection was finished.

I picked up the scalpel.

And before applying the knife, I went over the framework of the surgery in my head once more.

'Placenta Previa. A condition where the placenta is blocking the exit of the uterus.'

It was a level of difficulty on a completely different dimension from a normal Cesarean Section.

The biggest trap was the moment of making the incision.

In a normal Cesarean Section, even if you cut open the uterus, the baby is right beneath it.

But Placenta Previa is different.

Right beneath the blade, instead of the baby, a placenta rich in blood vessels lies in wait.

If I cut without thinking, a fountain of blood will surge from that placenta.

'This is why Obstetrics and Gynecology surgeries are so difficult.'

If you had to pick the department that sees the most blood after Trauma Surgery, it's surprisingly Obstetrics and Gynecology.

Because that area has a lot of dangerous blood vessels.

"Please turn up the lighting."

Tap, tap.

First, I shone a strong light on the uterus and gently felt it.

It was to gauge exactly where the placenta was attached.

'...Damn it. The placenta is attached to the anterior wall.'

In the uterus, which had become slightly translucent due to the strong light, the location where the placenta was attached could be roughly gauged.

Normally I would cut horizontally across the exact center, but doing that would end up touching the placenta.

So I decided to slightly shift the incision line.

"I'm cutting."

Gauging the location of the placenta, I avoided its edges and opened up the uterus.

I made a very slight horizontal cut at a location slightly off from the center.

'...Oh my. The placenta was bigger than it looked.'

As expected, gauging the location of the placenta from the outside using light and touch had low accuracy.

It seemed the placenta was bigger than it appeared.

As soon as I cut the uterus a little, the red tissue shyly revealed itself.

I modified my strategy immediately.

I twisted the tip of the knife that was cutting horizontally into a vertical direction.

In an inverted T-shape, I added a vertical incision line.

The mask of the Assistant Healer assisting from the side bobbed up and down.

"...It is a technique I have never seen before."

"It is an Inverted-T incision. It is a modified technique necessary for patients who are in danger with just a normal Cesarean Section, so keep it in mind."

After having a very brief education session with the Lafavre Sect healers.

I immediately widened the incision line.

"Prepare for suction. Stick close so my field of view isn't blocked."

"Yes."

Just as predicted, red blood surged fiercely.

Even avoiding the placenta as much as possible, it was to this extent.

This is why I hate Placenta Previa.

Because even with your best effort, the worst can happen.

My field of view was entirely dyed red.

I swiftly thrust my hand into the sea of blood, dodging the placenta this way and that.

"The baby is coming out!"

From deep within the uterus, a fetus-like baby covered in amniotic fluid and blood slid out into the world.

I cut the baby's umbilical cord and immediately handed the baby over to the Pediatric Healer who was on standby.

The standby Healer immediately began treatment.

A moment later, a booming cry rang through the operating room.

It was a booming cry that would not be lacking even if called general material.

...Even though she is a Princess.

"I will begin hemostasis."

The uterus the baby had slipped out of.

From that empty space, blood began to seep out.

Normally, a uterus from which the placenta has detached can contract on its own to achieve hemostasis.

But Placenta Previa is different.

Because the lower part of the uterus where the placenta was attached is a part where contraction is particularly weak.

It means it's a part where hemostasis doesn't happen well in the first place.

Furthermore, this patient was in a state that couldn't even be managed with Heal.

It was a significantly serious situation.

"...The bleeding is severe."

Tension was thick in the Assistant Healer's voice.

Perplexity also spread across the faces of the three people who were observing.

"T-Teacher..."

Ayla unknowingly took a step forward.

She was stamping her feet in a sense of powerlessness, unable to cast Heal even if she wanted to.

"Do not panic."

I said calmly, without stopping my hands.

"Did I not tell you from the beginning that it would turn out like this?"

This was not an unexpected situation.

It was a situation I had already predicted and prepared for.

A situation that is already sufficiently predicted and prepared for is no longer a danger.

It was the method my mentor from my previous life taught me to gather my composure when my hands trembled.

"We will begin the blood transfusion immediately. Squeeze in all 2 units, and continue to add more after that."

First, I gave the order immediately.

I started by replenishing the blood that was draining away.

At the same time, I placed both hands on the uterus.

I grabbed the flabby, sagging uterus forcefully from both sides and applied pressure.

I was manually applying pressure to the blood vessels where the blood was coming out.

"Oxytocin."

"It has been administered."

The first medication was administered.

A medication that makes the uterus contract to achieve hemostasis on its own.

Counting the time in my mind, I waited for the medicinal effect to circulate.

But even as time passed, it didn't seem like the medicinal effect was taking hold.

'It's still flabby.'

Just as a muscle becomes hard when force is applied to it.

When the medicinal effect circulates, the uterus is bound to become hard as well.

However, the Imperial Princess Consort's uterus did not respond to the Oxytocin.

The uterus was mushy like a deflated water balloon and did not contract properly.

Blood ceaselessly flowed down my gloves.

'As expected, this level of bleeding can't be controlled with just Oxytocin.'

I immediately brought in the second medication.

"Methylergonovine, via intramuscular injection, please."

An even more powerful uterine contraction agent made by tweaking Ergot.

The medication went in, and I observed the uterus's reaction.

The uterus became slightly firmer.

But the blood did not stop.

It was the fault of the bleeding area being too wide.

The medication was working.

However, this alone was not enough.

Jenny, having realized that fact, leaned her body forward.

"The hemostasis still isn't working. We need to cast Heal immediately..."

"Not yet."

She approached the operating table as if she would cast Heal right at this moment.

But I brought her to a halt.

The third card still remained.

"Prepare the balloon tamponade."

The Assistant Healer belonging to Lafavre brought the item I had spoken about in advance.

It was an item with a thin hose connected to a thin, tough pouch.

"T-This is...?"

The gazes of the Healers inside the operating room gathered on that item.

The balloon's name was the Bakri balloon.

It was something made like a balloon by sterilizing a demonic beast's bladder.

I pushed the wrinkly demonic beast bladder balloon deep into the open uterus.

And I pulled the hose connected to the balloon out through the vagina, passing through the cervix.

"The balloon's location is set."

"Good. Give me the Chromic catgut (chromic catgut)."

"Yes? Yes? Ah, the Chromic catgut."

The Apprentice Healer handed over the thread and needle while getting flustered.

They hadn't thought I would suddenly attempt suturing in this situation.

Pushing the feedback off for later, the Assistant Healer and I hurriedly received the thread.

"Be careful not to poke the balloon. We'll close the uterus first."

We diligently worked the needle and thread on the incision site that was barely visible because of the blood.

I briefly cast a glance at the Assistant Healer.

He also diligently attempted suturing, but he kept making mistakes because it was slippery from the blood.

Realizing my gaze, the Assistant Healer hurriedly offered an apology.

"I-I'm sorry."

"It is fine. In a field like this, it is something that can easily happen."

Normally, one doesn't attempt suturing in a state covered in blood.

Because you can't see, and it's slippery.

I also hate using thread in a situation full of blood.

But Trauma Surgery was not a department where one could do such complaining.

And Obstetrics and Gynecology is the same.

Over there, attempting suturing even when blood was overflowing was daily life.

"I will finish the suturing."

In the end, I sutured about 7/8 of the uterus's incision site.

Now it was the final stage.

"Put in the saline solution."

Pressing the piston of the syringe connected to the hose, I slowly pushed the saline solution in.

The closed uterus grew slightly larger.

The demonic beast's bladder had inflated from the inside.

The principle is simple.

The inflated balloon forcefully pushes against the entire inner wall of the uterus from the inside without any gaps, suppressing the bleeding area.

Drip, drop...

Soon, the red blood that had been gushing out through the vagina noticeably decreased.

And shortly after, it stopped completely.

"As expected, it's a good thing I prepared this."

The Bakri balloon.

It's a treatment method that received attention quite late in Obstetrics and Gynecology.

Was it around 2020 when the WHO recognized it?

I don't remember it well since it was something an Obstetrics and Gynecology Fellow had explained to me in passing, but...

At any rate, it's a technique that received attention late compared to its effect.

The reason such a simple-looking technique received attention late is simple.

Because in the past, rather than risking the danger, they would just go with a surgical removal of the uterus or tie off the blood vessels.

But if you just do a surgical removal of the uterus right away, wouldn't the patient's quality of life plummet?

As a result, this balloon technique, which is an intermediate stage between medication and surgery, came to receive attention.

'If this didn't work, I would have had to do a surgical removal of the uterus.'

This was a treatment that took the Imperial Princess Consort's stance into consideration.

Losing her uterus and losing her reproductive ability.

As a member of the Imperial Family, it would be a situation she'd want to avoid.

Of course, she already has two children.

Even so, an Imperial Princess Consort without a uterus could subtly run the risk of being left out in the cold within the Imperial Court.

Or is it not?

Does it not matter since there are already two imperial grandchildren?

I don't know the circumstances of noble society over there well, so I'm just guessing like that.

'If it didn't work even after a surgical removal...'

'Then I would have had to unfold a do-or-die 0.2-Second Divine Magic.'

Fortunately, there was no need to throw such a gamble this time.

Because the hemostasis was successful with just the balloon.

"The bleeding has been controlled. I will try a blood pressure measurement... Yes. It has returned to normal."

"Phew..."

Only then did I let out the long breath I had been holding back.

The three students were staring at the sight in a daze.

I spoke as if to ensure the people of the Lafavre Sect, including those three, would hear.

"Regarding the hemostasis techniques after a mother in childbirth gives birth, I plan to give an additional lecture at the conference later, so everyone, be sure to review."

""Yes!""

Hearing that I would teach them this technique too, everyone seemed to have their eyes sparkling.

*

The surgery ended, and both the mother in childbirth and the baby safely regained their stability.

Imperial Prince Edmund, who had been waiting outside the Recovery Room, grabbed both of my hands as soon as he saw me.

Awe was visible in his two eyes.

At the top of the operating room, there is an observation window through which guardians can look down at the surgery.

The Imperial Prince seemed to have watched the entire process through it.

"Lord Yulian... I am indebted to you twice now."

"That is my role, so you do not need to worry too much."

They say people who come to a University Hospital once can't go to other hospitals.

A connection with a patient you've seen once lasts longer than you'd think.

"It was exactly as you foresaw. That there would be bleeding, that you made the medication to stop it in advance... even that balloon."

He stared at me intently.

"Could it be... you can see the future?"

At that question, I let out a soft laugh.

"You overpraise me, Your Highness. For a Healer, looking at a patient's signs and assuming the worst situation that could happen to prepare for it is simply a natural, basic knowledge."

She's in a high-risk group.

It can all be predicted.

Going in with all of that under calculation is the basic knowledge of a 21st Century surgery.

Rather, it was the unexpected situations that popped up out of nowhere, making the words 'Why the fuck is this happening now?' come out automatically, that were difficult.

Compared to that, the Imperial Princess Consort's case was...

"Prediction is not that difficult a task. Even besides me, there are plenty of people in this Meyer Infirmary who know how to do this much."

This kind of prediction is not that difficult.

You just know it all if you read books and study.

Treating it as some kind of precognition was just embarrassing.

Then, the Imperial Prince, having heard my words, suddenly cast his gaze over my shoulder.

He seemed to be trying to confirm something.

Wondering what was going on, I also looked behind my back.

The Healers exiting the operating room were crossing their hands in an X shape and shaking their heads.

Then they made eye contact with me and hurriedly withdrew their arms.

Students, including Ayla, were also included among them.

Seeing those sights, I had no choice but to make a correction to the words I had just said.

"...I will make a correction. It is possible if you learn it all."

The Healers' eyes widened roundly.

Yes? Me?

It was a look that asked that.

Nodding my head wordlessly toward them, I spoke to the Imperial Prince.

"I will make them that way."

"...That is very reliable."