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Baby stopped breathing after birth due to lungs issue. Can this be prevented? Pregnancy again?

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My name is XXXXXXX XXXXXXX P,and i am from Andhra Pradesh.I had delivered a baby girl through c-section on 23rd march 2012 and our bad luck was the baby immediately expired with in 10-15min.It was my first delivery and i am completely depressed.Just before delivery also the fetal movements and heart rate were good.

my LMP is 12-06-2011 and my Husband is My Mothers Elder Brother Son.

The doctor told us that the baby was not able to take breath and there was some lungs problem.They were not able to tell the exact problem;the gynic told us that when the baby came out she cried for a second and immediately stopped crying,and the heart rate went low,then they immediately called a pediatrician very closeby and they tried to pump air in the mouth and tried pressing the heart,inspite of all the efforts the baby girl was not able to survive and she immediately died.


What i want to know is by the above symptoms,can we tell what the problem is and what can be the preventive steps to prevent this.The delivery happended in a district headquarter called "Anantapur" which is in Andhra Pradesh.Actually till ninth month starting we had consultation in Fernandez Hospital which is in Hyderguda,Hyderabad and every test perfomed was normal till that time[BP and sugar were also normal],so we came to our hometown for delivery.


The Doppler Test taken one day before the delivery is attached.According to Doppler the EDD is 25/04/2012
The ultrasound scans done on November and January are attached.According to Ultasound scan's and as per by gestational age, the EDD is 20th March 2012.
can you please explain Why this difference between ultrasound scan EDD and doppler Scan EDD?
Does this tell that Ultrasound Test is Not Reliable?
In the Attached Fetal Anamoly Report,it says the lungs are normal.Does this mean that after November the lungs didn't grow as expected (or) the Ultrasound Report is not precise?
Are there any tests which can access lung's functionality and tell us the complete lung growth?

Since i ahd a c-setion now,what is the gap i have to take for the next pregnancy and what preventive steps should i take to have normal delivery in the next pregnancy and the scans to undergo to know the well-being and abnormalities if any?
Posted Tue, 22 May 2012 in Women's Health
 
 
Answered by Dr. Chetna Jain 1 hour later
Hi XXXXXXX
Hope you are recovering well.
It sad to hear this news.
Your scan at 20 wks was fine.
Your next scan at 32 wks shows less water around baby.
A subsequent scan at 40 wks shows a size of 35 wks with abnormal doppler in fetal brain in MCA(middle cerebral artery) with less water again.
You should heave become cautious at the time of 32 wks scan which showed less water.
A close monitoring should have been done after that.
Did you have continuous fetal monitoring during labour(NST) if yes whether the graph was fine.If not, a fetal distress may go unrecognised.
The pediatrician should arrive before delivery more so in high risk cases.
Water around baby is crucial for lung developement.
You should have received 2 doses of steroids.You deliver past your due date which is not correct due to low AFI(water).
My advise for next pregnancy is
Get fit by eating healthy exercising well and take your iron folic calcium regularly.
You may plan 6-8 months down the line.
Do an USG at 7, 12, 20 , 24, 32 and 37 wks. Extra USg may be required if any abnormality is seen in them.
A very regular follow up.
Deliver at the place of ANC care and not chnage at the last minute.
Keep a regular fetal movement count from 26-28 wks onwards.
Plan next delivery after 37 wks completed weeks.
If for some reason delivery before 36 wks is required then do take antenatal steroid injections.
Let be gones be bygones.
Have faith and do your best.
Consanguinity sometimes can cause problems and its hard to say that the fetus was totally normal because a lot of things come in light after delivery and not all malformations or problems can be excluded antenatally

Above answer was peer-reviewed by
 
Follow-up: Baby stopped breathing after birth due to lungs issue. Can this be prevented? Pregnancy again? 24 minutes later
Hi Doctor,

Thanks For the Reply

For the Points
Your next scan at 32 wks shows less water around baby.
The AFI index is 12

A subsequent scan at 40 wks shows a size of 35 wks with abnormal doppler in fetal brain in MCA(middle cerebral artery) with less water again.
The AFI Index is 5cm

What should be the normal AFI index at 32,37 weeks and at 40 weeks?

Did you have continuous fetal monitoring during labour(NST) if yes whether the graph was fine.If not, a fetal distress may go unrecognised.
The NST was Good;it is even performed just one day before delivery and it was fine

You should have received 2 doses of steroids.You deliver past your due date which is not correct due to low AFI(water).
we have not received any dose of steriods.Does Post Date Delivery due to Low AFI is not correct?
Follow-up: Baby stopped breathing after birth due to lungs issue. Can this be prevented? Pregnancy again? 20 hours later
Forgot to Ask One More Question:

Can you please tell me Best Cream for the stretch marks to go that came during pregnancy
 
 
Answered by Dr. Chetna Jain 31 hours later
Hi
Went through your USG at 32 wks again ,AFI was normal then.
I hope you had regular checkups after that. Any growth restriction clinically could have been varified by USG.Because at 40 wks size was 35 wks suggesting that fetus grew only 3 wks in last 8 wks.
AFI values vary with gestation
Broadly an AFI of >8 cm is ok at 37-40 wks.
At 32 wks >9 cm is better and is commonly seen.
The exact values can be found out from a radiologist/ sonologist.
We take a cut off of 7 cm for delivery at term >37 wks and a cut of 5 cm at earlier gestations. But its the overall assessment of the patient and no single parameter can be dictating.
Whenever the patient shows any signs of abnormality in fetal or maternal well being steroid injections are given to enhance maturity so that in case of delivery before 36 wks baby breathes better after delivery.
Above answer was peer-reviewed by
 
Follow-up: Baby stopped breathing after birth due to lungs issue. Can this be prevented? Pregnancy again? 11 hours later
Thanks Doctor for your replies.

I Forgot to Ask One More Question:

Can you please tell me Best Cream for the stretch marks to go that came during pregnancy
 
 
Answered by Dr. Chetna Jain 5 hours later
Please moisturize your skin well.
You may try using placentrex gel.
You can also do laser removal.
Please see a dermatologist for better advise
Above answer was peer-reviewed by
 
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