In this remote area of Kenya, many babies and sometimes their mother have died during childbirth. A reported figure of 30% infant mortality was a very real concern. However, since the Order of Malta built the Maternity Theatre was formally opened last year, whilst tragic for the family, we have only lost one baby, which is truly a miracle.

We would like to thank again all the financial and moral supporters who helped build this project.

Father Timothy Mutie says:

“The Order of Malta maternity Theatre has brought a big difference to the community. Prior to it, we were unable to safely operate, so all mothers were referred to the County Hospital which is very far, a distance of over 120 kilometres on terrible roads. They had tried all other the possible traditional methods to give birth at home, so by the time they come to here they were in a critical condition, and we lost many babies, mothers and sometimes mothers and their babies, on the way to the County Hospital. Now we operate safely in Tangulbei.”

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Baby 4
A 25 year old lady with 2 living children on her 3rd Pregnancy . She was fully dilated when she came in, but normal spontaneous vertex delivery wasn’t possible due to foetal malposition (*occiput Posterior). Foetal distress had also ensued. We rushed in to perform an Emergency Caesarean Section.

The baby was unresponsive on delivery, new born resuscitation was initiated promptly but was unsuccessful. Unfortunately, we lost the baby. Rest in Peace. The mother was wheeled out of theatre in stable condition but had to be transferred to the County Referral Hospital for blood transfusion. She was anaemic prior and had also lost approximately a litre of blood during the procedure. We followed up on the case, blood transfusion and appropriate postoperative care was given and she was discharged in stable condition.

Reported by: Dr. Winfred Muendo: 29th September, 2023
Subsequently The Companions of Kenya donated a blood bank so transfusions could be done immediately.

Baby 5
5th November, 2023. An 18 year old lady, on her first pregnancy. She came in Active labour, at full cervical dilatation. Foetal descent was poor and the status of the foetus was also non reassuring (Irregular foetal heart rate with meconium stained liquor Grade II). An emergency Caesarean Section was done.

Outcome : A live male infant, weighing 3.5 kgs, Apgar score 6¹7⁵8¹⁰. On the first postoperative day, the new born was noted to be twitching, irritable and breastfeeding poorly. Appropriate management for hypoxic Ischaemic encephalopathy (HIE II) and Early Onset Neonatal Sepsis was started. He also developed jaundice and was put on phototherapy. The mother remained stable on postoperative antibiotics and analgesics.
On the second postoperative day, the baby’s condition remained the same, (still irritable and breastfeeding poorly, the jaundice had subsided). A decision to refer the baby for review by a paediatrician and admission at the County Hospital new born unit was made and implemented.

Baby 6
13th December, 2023. A 19 year old lady, on her first pregnancy. She came in latent phase of labour. Both the mother and foetus were stable. Monitoring of labour with the aid of a partograph was initiated once the action phase of labour began. She progressed to full cervical dilatation but foetal descent remained poor. One hour after the partographs action line had been crossed there was still no progress, despite adequate uterine contractions. The Foeta heart rate remained regular, 144 beats per minute+clear liquids Reassuring*). A diagnosis of prolonged labour was made, and the need for an emergency Caesarean Section was agreed upon. Informed Consent was obtained and the procedure was done successfully.

Outcome:
A live female infant weighing 2.8 kgs, Apgar score 8¹9⁵10¹⁰. Both the mother and the baby were discharged in stable condition on the 3rd postoperative day.

Baby 7
11th January, 2024. A 22 year old lady on her first pregnancy. She came in Active labour, progressed to full cervical dilatation but the descent of the foetus remained poor. Examination of the pelvis revealed possible Cephalopelvic Disproportion (CPD). A significant finding of Foul smelling liquid was also noted and subsequent administration of broad spectrum IV antibiotics initiated. A diagnosis of Obstructed Labour secondary to cephalopelvic disproportion + Chorioamnionitis was made, prompting the decision to perform an emergency Caesarean Section. The procedure was done successfully.

Outcome: A live female infant weighing 3.1 kgs, Apgar Score of 7¹8⁵10¹⁰.
Both the mother and the baby were discharged on the third postoperative day in stable
condition.

Baby 8
9th February, 2024. A 17 year old lady on her first pregnancy. She came in latent phase of labour. Monitoring of labour with the aid of a partograph was initiated once she entered the active phase. Despite adequate uterine contractions, she was stuck at a cervical dilatation of 7 cm for over 6 hours. Descent remained at 3/5. No features of foetal distress were noted. A diagnosis of poor progress of labour was made and a Caesarean Section performed.

Outcome: A live female infant weighing 3.2 kgs, Apgar score: 9¹ 10⁵ 10¹⁰. Both the baby and mother were discharged on the 3rd postoperative day in Stable Condition.

Baby 9
7th March, 2024. A 21 year old mother of 2 on her 3rd pregnancy. She reported to have delivered at home previously. Both children are alive and well. She was brought in by her brother in law , having labored at home for 2 days. On examination, her vitals were within normal ranges, the fetal heart rate was present and regular but the fetal lie was Transverse. Further examination (VE) revealed cervical dilatation of 7 cm and an intact amniotic sac that ruptured spontaneously resulting to a prolapsed arm. A diagnosis of Fetal Malpresentation (+ an arm prolapse) was made and an informed consent to proceed with an emergency caesarean section was obtained.

Outcome: A live female infant, weighing 1920 grammes (*Low Birth Weight), Apgar Score of 8¹9⁵10¹⁰. Today is the 2nd postoperative day and both the mother and baby are doing well.