Dear,

It's sad to note such a mishap. Following is the explanation for the same;

1. The sonography reports do suggest that child was premature even though dates show full term (dates can go wrong). Premature babies have a probability of having underdeveloped lungs, that fail to breath and can cause serious issues if not intervened in minutes. Further heavy (2.5 Kg) premature babies also may be related to sugar disturbances in mother, such instances can complicate the matter.
2. If the pediatrician had arrived late (which I hope it is not) within 10 minutes, the golden hour for resuscitation may have lapsed. Complications are higher if golden hour had elapsed.
3. Reason for Caesarian section isn't understood; maybe it was due to oligohydramnios. A Non Stress Test (NST) test before surgery would have helped to know if baby had problem inside the womb.

I understand you would have been deeply hurt by this event. My suggestion for prevention are:

1. Register for delivery at a central institute like say Apollo Hospital, which has a Neonatal Intensive Care Unit (NICU) attached and has a pediatric doctor available round the clock.
2. Insist for presence of one relative and also a pediatrician inside Operation Theater or labour room even before baby is born.
3. Get evaluated before next pregnancy for mother's and father's chromosomal studies.
4. Conduct fetal anomaly scan in first trimester. Blood Pressure and sugar needs to be checked regularly during pregnancy. Let mother be on folic acid and iron supplements in advance.
5. Frequent monthly Ultrasound/ doppler to check circulation/placenta will help.
6. NST whenever any issue is noted like say leaking, infection, fever , labour pains etc, will help understand distress to baby and take adequate measures if feasible.

Right now, Visit a psychological counsellor to adjust coping with depression , especially for mother.

Hope this helps. Thanks for the query. Feel free to ask any further query if any.

Regards

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well XXXXXXX,
Prematurity is defined by 37 completed weeks of gestation (pregnancy). As per dates the child was near term. If any USG had mentioned EDD depending on calculations from fetus head size or femur length, then only there would have been some chance for prematurity. If the mother sugar was normal then the large birth weight premature chapter should close. I had to mention prematurity as that is one of top causes by which a child lungs cant expand. the other reasons can be aspirating amniotic fluid, or blood in throat, or may be rare congenital anomaly where there would have been serious defect of lung formation.
USG can mention EDD. Doppler is indicated only when some problem is suspected, like say oligohydramnios, so need not be done routinely. Oligohydramnios is also associated with fetal kidney issues, though not a single event can be blamed 100 percent. I will not recommend you getting into extreme details of medical jargon. What you should understand that we can take extra precaution next time as i had suggested in previous reply.


Anomaly scans too can miss many such issues (like lungs normal, as in uterus lungs dont contain air), especially when they do such scan with routine USG probes (fetal scans need high resolution say 5 HZ probes- which most centers do not have). But despite given the best possible facilities its possible to have no justifiable reason if the PostMortem report is also normal.
NST was good, so that (fetal distress) wasnt the reason for emergency section.

I hope this addresses your concerns. Please accept the answer.

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