We began the day with animated discussions about the ultrasound topics. Many of the participants were eager to review their new skills and hone their understandings of landmarks, troubleshooting and recognition of obstetric sonographic emergencies.
The director here in Haiti, Dr. Aupont requested lectures on interpretation of Doppler in obstetrics. This took place today and was probably the most interesting and difficult lecture topic to date. Three different lecturers presented the information, and by the third lecture most participants said ‘ahh’. They finally got it. We instructors were not sure how essential this area was to obstetric emergency recognition. This fact was quickly dispelled in the afternoon session.
We staffed 5 scanning rooms. In one ‘hands on’ session, two patients presented with growth restricted fetuses. Both had fetal oligohydramnios. The participants were eager to perform umbilical artery Doppler. When we did, we found severely abnormal Doppler for one of the women. She was taken to the labour ward (after queries about pre-eclampsia) and diagnosed with severe pre-eclampsia. This experience reinforced the didactic session from the morning: the ultrasound findings on this patient resulted in her prompt treatment of severe pre-eclampsia. Untreated the condition could have resulted in eclampsia and possibly maternal death.
The scanning rooms are like ovens, but none of the participants seem to mind and demonstrate an enthusiasm that is infectious. These physicians (family physicians, interns, obstetricians) are determined to use this knowledge and information to help the women and children they care for.
During lunch, we received a wondeful education session about development activities supported by the Rava Foundation. The Foundation sponsors Haitians to travel to Italy to learn about baking techniques. As a result, we toured the pizza, bread and pasta making factory where we enjoyed pizza with all the ultrasound course participants and Emma Baiardi.