DELIVERY OF AN ALIVE FOETUS THROUGH CAESAREAN SECTION IN A CASE OF DECLARED MATERNAL DEATH

Rahat -un- Nisa, Rubina Bashir, Hizb ullah

Abstract


A 25 years old multipara having full term pregnancy
was being treated at Civil Hospital Haripur, for septic
meningitis while she suddenly went into cardiac arrest.
Resuscitation was started immediately by intubation,
ventilation and external cardiac massage and the
patient was shifted to CCU of DHQ (Teaching)
Hospital, Abbottabad, where she was declared dead
however Fetal Heart Sound (FHS) was still audible at
a rate of 40/min. She was shifted to Women and
Children Hospital, Abbottabad for further
management of the foetus while keeping the dead
body on positive pressure ventilation (total duration of
transfer time was not less than 44 minutes). The
obstetrician found no heart sounds and fixed dilated
pupils in the mother while the FHS were present at a
rate of 35/min. Decision to carry out postmartal Csection was made. An alive baby with apgor score of
1/10 was delivered through midline lower abdominal
incision of abdominal wall and a vertical uterine
incision in a bloodless field. While suturing the
incisions, bleeding started from the wounds and a
hectic effort was, than, made to resuscitate the patient.
Her heart rhythm came back and it started beating at a
steady rate of 80/min while her systolic blood pressure
was raised to 80 mm Hg. However, she still remained
deeply comatose and without sings of spontaneous
respiration. She eventually died 48 hours later. Foetus
was resuscitated successfully and on follow up
remains healthy and without any neurological deficit.

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