INTRODUCTION ;BY DEFINITION THEY ARE 20-24 WEEKS OF GESTATION OR MORE.THEY ARE BORN DEAD WITH ZERO APGAR SCORE.THE EYE BROWS OF ALL THE READERS MAY RAISE AS THE QUESTION OF LIFE DOES NOT ARISE IN A BABY PROCLAIMED AND CERTIFIED DEAD BY A QUALIFIED. DOCTER.HOW CAN THEY BE REVIVED?
WHAT HAPPENS IN THE FIELD? THEY ARE OFTEN LEFT WITHOUT ANY ATTEMPT FOR
RESUSCITATION.THIS IS A FACT.
ABSTRACT; 0.1--0.2% ARE REVIVABLE PROVIDED THEY ARE1)24--28 WEEKS OF GESTATION AT LEAST.2)IMMEDIATE AGGRESSIVE NEONATAL RESUSCITATION DONE AS PER AUTHOR'S CONCEPT.3)PREFERABLY THERE ARE NO ASSOCIATED CONDITION LIKE . RDS.,TEF, CONGENITAL DEFECTS COEXISTING DURING RESUSCITATION
KEY WORDS;--APGAR SCORE, ET-TUBE+AMBU BAG,METABOLIC ACIDOSIS,ABC/CPR.
,UMBILICAL CATHETRISATION,FOETAL CIRCULATION,,DEFIBRILLATION,FOETAL DISTRESS,,DEATH CERTIFICATE
MATERIALS & METHODS
------------------------------
CASE 1.UNBOOKED CASE. G3 P3.CONCEPTION 32 WEEKS.AFTER INITIAL LABOUR PAIN
NO FURTHER PAIN FOR 3 HRS..EIDEAD BABENCE OF FOETAL DISTRESS.INDUCTION TRIED.VAGINALLY DELIVERED A DEAD BABY.2 KG WT.APGAR SCORE ZERO .FULL FLACCIDITY OF ALL MUSCLES.MATERNAL AGE 37.
CASE 2 .UNBOOKED CASE MATERNAL AGE 35 PRIMI PARA WITH SEVERE PAIN.HEAD NOT VISIBLE.NO SATISFACTORY CONTRACTIONS.FOETUS DEAD. MANUALLY REMOVED
WT-2.2 KG.GESTATION-36 WEEKS.APGAR ZERO.MUSCLE TONE FLACCID.
CASE 3 UNBOOKED CASE. LABOUR PAIN ON &OFF.GESTATION32 WEEKS PITOCIN DRIP STARTED VAGINALLY DELIVERED.CORD AROUND NECK TWICE APGAR ZERO.FULL FLACCIDITY OF ALL MUSCLES.MATERNAL AGE-38
AUTHER'S CONCEPT: ALL NEONATES WITH APGAR LESS THAN 5 DO SUFFER FROM METABOLIC ACIDOSIS. THOSE WITH ZERO APGAR SUFFER FROM HIGHEST ACIDOSIS (LOWEST BLOOD PH.IMMEDIATE CORRECION OF ACIDOSIS AS PER AUTHER'S PROCEDURE ALONE COULD CORRECT &REVIVE.THE PRESENT CONCEPT OF A B C &CPR ARE WASTE OF TIME &SHOULD BE PREFERABLE AVOIDED.AUTHER WOULD HAVE SEN ATLEAST OVER 20 CASES BUT NONE HAS SURVIVED,INSTEAD STIMULATION BYTACTILE/TRACEAL/DRUG/ELECTRICAL STIMULATION(DEFIBRILLATION) MAY HELP.
AUTHER'S REVIVAL PROCEDURE; AUTHER HAS REVIVED3 STILL BORN BABIES &CARRIED OUT SAME PROCEDURE TO ALL AS FOLLOWS:--
1)CUT UMBILICAL VEIN &CATHETERISE& ENTER INTO INFEROR VENA CAVA
2)PUSH SLOWLY 7.5 % SODA BICARB +20% GLUCOSE,10 ML EACH.
3)WAIT FOR 2 MTS ,WHILE DOING TRACHEAL SUCTION,CHEST SQUEEZING TO TAKE UP RESPIRATORY EXCURSIONS IF INITIATED
4)REPEAT DOSE AFTER 2 MTS IF NO RESPONSE IN CVS/RS
5)IF NO RESPONSE IN 2 MTS STILL GIVE THE FOLLOWING ---SODABICARB10 ML ,20% GLUCOSE 10 ML+DERIPHYILINE 0.25 ML+INJ ADRENALINE-2 DROPS
6) IF STILL NO IMPROVEMENT ,,DEFIBRILLATION ADVISED
pathophysiology;DURING THE PROCESS OF LIFE ANABOLISM &CATABOLISM CONTINUE IN THE TISSUES OF FOETUS .WHEN THERE IS FOETAL DISTRESS ACCUMILATIN OF WASTE MATERIALS,LIKE ACETO- ACETIC ACID,BETA HYDROXY BUTRIC ACID,UREA,URICACID ACCUMULATE &THESE DO NOT DIFFUSE FROM FOETAL TO MATERNAL PLACENTA RESULTING IN FURTHER ACCUMULATION ONCE FOETAL CIRCULATION STOPS(FOETAL DEATH).THIS INCREASES BLOOD PH(ACIDOSIS)WHICH CAN NOT BE NEUTRALISED BY COMPENSATORY RESPIRATORY ALKALOSIS AS THE LUNGS DONT FUNCTION &PLACENTA GETS SEPARATED BY ITSELF PREMATURELY IN SUCH BABIES.
ASSESSMENT OF BLOOD PH ; CORD BLOOD MUST BE SUBJECTED TO LAB TEST IMMEDIATELY FOR BLOOD PH &LATER AFTER REVIVAL,TO PROVE PRESENCE OF METABOLIC ACIDOSIS.
DRUG DOSE CALCULATIONS :--NAHCO3--7.5%--5 ML /KG/DOSE, 20%GLUCOSE 5 ML/KG/DOSE.REPETITION REQUIRED AFTER EVERY 2 MINUTES TILL CLINICAL SIGNS--APGAR SCORE IMPROVES
DEFIBRILLATION;-WHILE ATTEMPTING TO REVIVE 95-99 % LIKELY TO REMAIN DEAD
.
SUCH CASES NEED DEFIBRILLATION AS THE LAST CHANCE FOR SURVIVAL SINCE EACH BABY IS PRECIOUS FOR ITS MOTHER AUTHER HAS NOT SEEN PEDIATRIC DEFIBRILLATER IN MANY MAJOR HOSPITALS, INCLUDING ANY TEACHING INSTITUTION IN CHENNAI..
SUMMARY:3 CASES OF STILL BORN BABIES SUCCESSFULLY REVIVED BY A NEW CONCEPT OF DRUG STIMULATION FORGETTING THE OLD DICTUM OF ABC &CPR
CONCLUSION; STILL BORN BABIES ARE ALSO REVIVABLE PROVIDED PROPER CARE IS TAKEN.2,84000 BABIES DIE AT THE TIME OF BIRTH GLOBALLY EVERY YEAR.LITERATURE IS AVAILABLE ABOUT SURVIVAL OF BABIES PROCLAIMED DEAD.THESE HAVE BEEN DOCUMENTED AMPLY---SOME EXAMPLES AS FOLLOWS;IT IS STRESSED THAT EVEN IF APGAR SCORE IS ZERO SUCH BABIES NEED RESUSCITATION TO BE CARRIED OUT WITH INTRA UMBILLICAL SODABICARB WITH OTHER SUPPORTIVE MEASURES LIKE DEFIBRILLATION
REFERENCES:
1)CHINESE BABY SURVIVES BEING BURIED ALIVE AFTER PARENTS THOUGHT THE PREMATURE BABY WAS STILL BORN--CHRISTIAN TODAY,9-12 14
2)CHINESE NEW BORN BABY SURVIVED BEING BURIED ALIVE 2 HRS AFTER PARENTS THOUGHT SHE WAS STILL BORN--THE INQUISTER,7-12-14
3)STILL BORN BABY SURVIVES-METRO,5-12-14
4)PREMATURE BABY SURVIVES BEING BURIED ALIVE--LIFE NEWS.COM 5-12-14
5)CHINESE BABY SURVIVES--SHE WAS STILL BORN-CHRISTIAN TODAY 8-12-14
6)SCHOTT J HENLEY A KOHNER 2007 ,PREGNANCY LOSS &DEATH OF A BABY GUIDE LINES FOR PROFESSIONALS 3 rd ed SANDS SHEPPERTON ON THAMES BORAN PRESS.
7)RADESTAD.L 2001 STILL BIRTH CARE &LONG TERM OUTCOME FOR MOTHERS WHO HAVE OR HAVE NOT HELD STILL BORN BABY.Br.J.MIDWIFERY 25 (4)422 -9
8)CONDE AYUDELOA, ROSES BERMUDEZ A KAFURY-GOETA AC 2006 BIRTH SPACING &RISK OF ADVERSE PERINATAL OUTCOME A META ANALYSIS.JAMA.295(15)1809-23
drselvarajp@yahoo.com ph ;9841354335
WHAT HAPPENS IN THE FIELD? THEY ARE OFTEN LEFT WITHOUT ANY ATTEMPT FOR
RESUSCITATION.THIS IS A FACT.
ABSTRACT; 0.1--0.2% ARE REVIVABLE PROVIDED THEY ARE1)24--28 WEEKS OF GESTATION AT LEAST.2)IMMEDIATE AGGRESSIVE NEONATAL RESUSCITATION DONE AS PER AUTHOR'S CONCEPT.3)PREFERABLY THERE ARE NO ASSOCIATED CONDITION LIKE . RDS.,TEF, CONGENITAL DEFECTS COEXISTING DURING RESUSCITATION
KEY WORDS;--APGAR SCORE, ET-TUBE+AMBU BAG,METABOLIC ACIDOSIS,ABC/CPR.
,UMBILICAL CATHETRISATION,FOETAL CIRCULATION,,DEFIBRILLATION,FOETAL DISTRESS,,DEATH CERTIFICATE
MATERIALS & METHODS
------------------------------
CASE 1.UNBOOKED CASE. G3 P3.CONCEPTION 32 WEEKS.AFTER INITIAL LABOUR PAIN
NO FURTHER PAIN FOR 3 HRS..EIDEAD BABENCE OF FOETAL DISTRESS.INDUCTION TRIED.VAGINALLY DELIVERED A DEAD BABY.2 KG WT.APGAR SCORE ZERO .FULL FLACCIDITY OF ALL MUSCLES.MATERNAL AGE 37.
CASE 2 .UNBOOKED CASE MATERNAL AGE 35 PRIMI PARA WITH SEVERE PAIN.HEAD NOT VISIBLE.NO SATISFACTORY CONTRACTIONS.FOETUS DEAD. MANUALLY REMOVED
WT-2.2 KG.GESTATION-36 WEEKS.APGAR ZERO.MUSCLE TONE FLACCID.
CASE 3 UNBOOKED CASE. LABOUR PAIN ON &OFF.GESTATION32 WEEKS PITOCIN DRIP STARTED VAGINALLY DELIVERED.CORD AROUND NECK TWICE APGAR ZERO.FULL FLACCIDITY OF ALL MUSCLES.MATERNAL AGE-38
AUTHER'S CONCEPT: ALL NEONATES WITH APGAR LESS THAN 5 DO SUFFER FROM METABOLIC ACIDOSIS. THOSE WITH ZERO APGAR SUFFER FROM HIGHEST ACIDOSIS (LOWEST BLOOD PH.IMMEDIATE CORRECION OF ACIDOSIS AS PER AUTHER'S PROCEDURE ALONE COULD CORRECT &REVIVE.THE PRESENT CONCEPT OF A B C &CPR ARE WASTE OF TIME &SHOULD BE PREFERABLE AVOIDED.AUTHER WOULD HAVE SEN ATLEAST OVER 20 CASES BUT NONE HAS SURVIVED,INSTEAD STIMULATION BYTACTILE/TRACEAL/DRUG/ELECTRICAL STIMULATION(DEFIBRILLATION) MAY HELP.
AUTHER'S REVIVAL PROCEDURE; AUTHER HAS REVIVED3 STILL BORN BABIES &CARRIED OUT SAME PROCEDURE TO ALL AS FOLLOWS:--
1)CUT UMBILICAL VEIN &CATHETERISE& ENTER INTO INFEROR VENA CAVA
2)PUSH SLOWLY 7.5 % SODA BICARB +20% GLUCOSE,10 ML EACH.
3)WAIT FOR 2 MTS ,WHILE DOING TRACHEAL SUCTION,CHEST SQUEEZING TO TAKE UP RESPIRATORY EXCURSIONS IF INITIATED
4)REPEAT DOSE AFTER 2 MTS IF NO RESPONSE IN CVS/RS
5)IF NO RESPONSE IN 2 MTS STILL GIVE THE FOLLOWING ---SODABICARB10 ML ,20% GLUCOSE 10 ML+DERIPHYILINE 0.25 ML+INJ ADRENALINE-2 DROPS
6) IF STILL NO IMPROVEMENT ,,DEFIBRILLATION ADVISED
pathophysiology;DURING THE PROCESS OF LIFE ANABOLISM &CATABOLISM CONTINUE IN THE TISSUES OF FOETUS .WHEN THERE IS FOETAL DISTRESS ACCUMILATIN OF WASTE MATERIALS,LIKE ACETO- ACETIC ACID,BETA HYDROXY BUTRIC ACID,UREA,URICACID ACCUMULATE &THESE DO NOT DIFFUSE FROM FOETAL TO MATERNAL PLACENTA RESULTING IN FURTHER ACCUMULATION ONCE FOETAL CIRCULATION STOPS(FOETAL DEATH).THIS INCREASES BLOOD PH(ACIDOSIS)WHICH CAN NOT BE NEUTRALISED BY COMPENSATORY RESPIRATORY ALKALOSIS AS THE LUNGS DONT FUNCTION &PLACENTA GETS SEPARATED BY ITSELF PREMATURELY IN SUCH BABIES.
ASSESSMENT OF BLOOD PH ; CORD BLOOD MUST BE SUBJECTED TO LAB TEST IMMEDIATELY FOR BLOOD PH &LATER AFTER REVIVAL,TO PROVE PRESENCE OF METABOLIC ACIDOSIS.
DRUG DOSE CALCULATIONS :--NAHCO3--7.5%--5 ML /KG/DOSE, 20%GLUCOSE 5 ML/KG/DOSE.REPETITION REQUIRED AFTER EVERY 2 MINUTES TILL CLINICAL SIGNS--APGAR SCORE IMPROVES
DEFIBRILLATION;-WHILE ATTEMPTING TO REVIVE 95-99 % LIKELY TO REMAIN DEAD
.
SUCH CASES NEED DEFIBRILLATION AS THE LAST CHANCE FOR SURVIVAL SINCE EACH BABY IS PRECIOUS FOR ITS MOTHER AUTHER HAS NOT SEEN PEDIATRIC DEFIBRILLATER IN MANY MAJOR HOSPITALS, INCLUDING ANY TEACHING INSTITUTION IN CHENNAI..
SUMMARY:3 CASES OF STILL BORN BABIES SUCCESSFULLY REVIVED BY A NEW CONCEPT OF DRUG STIMULATION FORGETTING THE OLD DICTUM OF ABC &CPR
CONCLUSION; STILL BORN BABIES ARE ALSO REVIVABLE PROVIDED PROPER CARE IS TAKEN.2,84000 BABIES DIE AT THE TIME OF BIRTH GLOBALLY EVERY YEAR.LITERATURE IS AVAILABLE ABOUT SURVIVAL OF BABIES PROCLAIMED DEAD.THESE HAVE BEEN DOCUMENTED AMPLY---SOME EXAMPLES AS FOLLOWS;IT IS STRESSED THAT EVEN IF APGAR SCORE IS ZERO SUCH BABIES NEED RESUSCITATION TO BE CARRIED OUT WITH INTRA UMBILLICAL SODABICARB WITH OTHER SUPPORTIVE MEASURES LIKE DEFIBRILLATION
REFERENCES:
1)CHINESE BABY SURVIVES BEING BURIED ALIVE AFTER PARENTS THOUGHT THE PREMATURE BABY WAS STILL BORN--CHRISTIAN TODAY,9-12 14
2)CHINESE NEW BORN BABY SURVIVED BEING BURIED ALIVE 2 HRS AFTER PARENTS THOUGHT SHE WAS STILL BORN--THE INQUISTER,7-12-14
3)STILL BORN BABY SURVIVES-METRO,5-12-14
4)PREMATURE BABY SURVIVES BEING BURIED ALIVE--LIFE NEWS.COM 5-12-14
5)CHINESE BABY SURVIVES--SHE WAS STILL BORN-CHRISTIAN TODAY 8-12-14
6)SCHOTT J HENLEY A KOHNER 2007 ,PREGNANCY LOSS &DEATH OF A BABY GUIDE LINES FOR PROFESSIONALS 3 rd ed SANDS SHEPPERTON ON THAMES BORAN PRESS.
7)RADESTAD.L 2001 STILL BIRTH CARE &LONG TERM OUTCOME FOR MOTHERS WHO HAVE OR HAVE NOT HELD STILL BORN BABY.Br.J.MIDWIFERY 25 (4)422 -9
8)CONDE AYUDELOA, ROSES BERMUDEZ A KAFURY-GOETA AC 2006 BIRTH SPACING &RISK OF ADVERSE PERINATAL OUTCOME A META ANALYSIS.JAMA.295(15)1809-23
drselvarajp@yahoo.com ph ;9841354335
