Новорожденный пролежал 12 часов в холодильнике
По словам Рут Фреттс, специалиста по мертворождению, мать ребенка рожала на 26 неделе. Во время родов ей дали успокоительное. Судя по всему, анестезия подействовала на ребенка (возможно, было нарушено дыхание). В итоге врачи госпиталя Perrando de Resistencia подумали, что девочка мертва, не выявив у нее признаков сердцебиения. Так была констатирована смерть.
Как отмечает Фреттс, во многих развивающихся странах показатели мертворождения столь высоки, что часто медики не борются за детей, рожденных раньше срока. Это может привести к страшному исходу - живого ребенка примут за мертвого.
Между тем, у недоношенных детей организм защищается, вырабатывая стрессовые гормоны. Именно это позволило аргентинской девочке выжить. Но гипотермия, наблюдаемая при рождении, ввела врачей в заблуждение. Сейчас в клинике проводится служебное расследование.
Оригинал статьи: "'Miracle baby': Vital signs may have been overlooked
by Chelsea Whyte
A PREMATURE newborn declared dead at birth was found alive this week after spending 12 hours in the refrigerated room of an Argentine morgue.
Her parents had returned to the hospital the evening after her birth to take a picture of their baby for the funeral. Instead of the lifeless body they were expecting, Analia Bouter and Fabian Veron found their daughter alive and crying in her coffin. Bouter calls it a miracle. A week after the ordeal, the baby is in a critical but stable condition.
So what happened? It's not so much a miracle as a misdiagnosis, says Ruth Fretts, a stillbirth researcher and obstetrician at Harvard Vanguard Medical Associates in Wellesley, Massachusetts.
Bouter was 26-weeks pregnant when she gave birth and was sedated during labour. The anaesthesia would have affected her child, says Fretts, and may have contributed to the misdiagnosis. But an experienced clinician should have been able to spot this.
"They could hear the heartbeat with a paediatric stethoscope. But the baby wouldn't have made much effort to breathe," says Fretts, referring to respiratory distress which results in reduced lung function in many premature babies.
However, medics at Perrando de Resistencia Hospital in Chaco, Argentina couldn't find a pulse in Luz Milagros, and she was declared stillborn.
"A trained person should know the difference between a sedated baby and a dead baby," Fretts says. But any effort to resuscitate a stillborn baby will be based on the viability of the infant's survival. In many developing countries, the rates of stillbirth are so high that a baby born three months prematurely might be considered an inevitable loss and "the signs of life could be overlooked," she says.
"In the periviable period (a narrow window between 22 and 26 weeks of gestation that almost universally results in stillbirth or neo-natal death) there can be a fair bit of misclassification," says Fretts. "In a setting where the chances of survival are low, they're probably not looking very hard for a baby with a heartbeat because they know what the outcome is going to be."
It's even more confounding, then, that this happened in a country where the rate of stillbirth is fairly low, with 5 in every 1000 babies being stillborn, a rate that has dropped by over 60 per cent since 1995 (The Lancet, vol 377 p 1319).
Fretts says that babies who are small for their gestational age produce stress hormones that help them adapt to life outside the womb. This survival mechanism could have kicked in for Bouter's child, especially if she was underweight as well as premature.
"If the baby was crying 12 hours later, my guess would be that it was further along in gestation than they thought, and the expectation that the baby wouldn't live coloured their view, so they didn't look too carefully."
The hospital's director, Jose Luis Meirino, said that all the staff present at the birth concluded that Luz was stillborn.
Meirino says hypothermia may have disguised her vital signs, but said in a statement: "At the moment we have no explanation."
The medical staff involved, including an obstetrician, a gynaecologist and a neonatologist have been suspended while authorities investigate.
Bouter says she plans to sue the hospital for malpractice."