Any advice on pre-term delivery?

[tangent]

Dead mom, 7-8mo term...

Just curious...

-t

[Austerenurse]

I would say a peri-mortem c-section delivery would be worth a shot in RAWTHM setting if you had the skill and equipment and:

Estimated gestational age is close to 28 weeks. The last thing you want to deal with in the RAWTHM is looking after a premature peri-mortem delivery.

Dead of the mother occurred minutes ago... ideally less than five, never longer than fifteen.

Ideally if you are moving past the five minutes window since maternal death that effective BCLS and/or ACLS were undertaken

There is some way to look after the child post delivery.

Technique.

1) Confirm death of the mother. Call a time of death.
2) Continue with CPR
3) Don't mess around with the traditional Pfannenstiel incision but go big and mid line. Using the utmost care not to lacerate the baby.
4) Deliver the child in the normal c-section manner
5) Resuscitation of the new born child


AN

[tangent]

OK, any thoughts on expedient neo-natal incubators? I seem to recall a book that talked about cardboard boxes, poss plastic lined... Very old - 50's or 60's CD stuff.

What about care and survival possibilities so many days pre-term? Like feeding? Warmth? Make do ICN stuff...

I recall an article in Omni Magazine (?) about transplanting a fetus into a male body many years ago. Apparently, a fetus is an excellent parasite - but they kick and lacking a females "padding" bringing a kid to term in such a situation is likely to be a painful situation.

-t

[Austerenurse]

I know close to nothing about neonatology. I do know that neonates are in for a worse-that-first-world ride in RAWTHM setting even if they do survive.

I have seen an incubator made out of plywood with a 40 watt light bulb in it when I was in Sri Lanka. Staff said it worked well. No references, but would be interested to see them if anyone has them.

AN

[pa4ortho]

the most important part of any incubator whether it is for bacteria, chicken eggs, or neonates is the thermostat. Otherwise you have an easy bake oven.

Of the kids needing resucitation 90% are simple: maintain airway, stimulate to breath, keep warm. The other 10% wont make it in a harsh environment.

I have never done this but watched it once. when opening the uterus to avoid cutting the kid and alow rapid action in a dead mom. make a small shallow cuts, amniotic fluid comes out, place the scalple with the blunt side just proximal to the tip of your index finger, slide your index finger in the hole and the scalple acts like a rescue knife cutting where the tip of your finger guides without going deeper.

pa4ortho