DELIVERY OF AN ALIVE FOETUS THROUGH CAESAREAN SECTION IN A CASE OF DECLARED MATERNAL DEATH
AbstractA 25 years old multipara having full term pregnancywas being treated at Civil Hospital Haripur, for septicmeningitis while she suddenly went into cardiac arrest.Resuscitation was started immediately by intubation,ventilation and external cardiac massage and thepatient was shifted to CCU of DHQ (Teaching)Hospital, Abbottabad, where she was declared deadhowever Fetal Heart Sound (FHS) was still audible ata rate of 40/min. She was shifted to Women andChildren Hospital, Abbottabad for furthermanagement of the foetus while keeping the deadbody on positive pressure ventilation (total duration oftransfer time was not less than 44 minutes). Theobstetrician found no heart sounds and fixed dilatedpupils in the mother while the FHS were present at arate of 35/min. Decision to carry out postmartal Csection was made. An alive baby with apgor score of1/10 was delivered through midline lower abdominalincision of abdominal wall and a vertical uterineincision in a bloodless field. While suturing theincisions, bleeding started from the wounds and ahectic effort was, than, made to resuscitate the patient.Her heart rhythm came back and it started beating at asteady rate of 80/min while her systolic blood pressurewas raised to 80 mm Hg. However, she still remaineddeeply comatose and without sings of spontaneousrespiration. She eventually died 48 hours later. Foetuswas resuscitated successfully and on follow upremains healthy and without any neurological deficit.
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