Another hand-prolapse . . . but luckier . . .

SB never thought that she would end up in this state. It was her second baby. She had an uneventful home delivery 3 years back.

SB's pains had started on Friday early morning and she was from near the hospital. She realised that something was amiss by late evening. However, her relatives insisted that she wait for some more time before going to hospital. And to supplant the patient's efforts, one intramuscular injection of oxytocin was also given.

It could have been a dangerous wait - at around 10 pm, plopped out the hand from her birthcanal. Her relatives understood that this was quite dangerous. They knew that she had to rush straight to NJH. Although her house was not much far from hospital, they could reach only at around 12:30 pm.

As usual, after a quite busy day I was getting into sleep mode when the call came. The nurse informed me that she was not sure about the fetal heartbeat. After the last patient who had come with hand prolapse I was sure that this was also not going to be much different. I was wrong. As I kept my hand on the abdomen of the patient, I felt I got a kick from the fetus.

Yeah, the fetal heart beat was present. And quite well. Everything happened so fast after that. The baby had a poor APGAR score but the theatre staff did a good job with resuscitation. This was the second baby over the last 3 months who came out alive after a hand prolapse. In fact, the previous one was quite fresh in my mind. As was expected, the hand was quite edematous. But, it has settled over time.

We did quite a good job with using the improvised CPAP for this baby too. And we thank the Lord that he has done good.

Working in resource poor settings . . .

It was about a week ago that one of our visitors initiated a discussion on innovative methods to get things done especially in settings like ours. Of course, one of the best examples which has been used is the Newmon ventilator which has served us quite well.


In my previous stinct, my colleagues had somehow improvised an airway circuit to give continuous positive airway pressure for sick babies. It was quite a simple circuit and had worked wonders in saving quite a number of premature and sick babies.



The thought lingered on for about couple of days before a preterm baby was delivered at NJH. To make matters worse, the baby was not keeping saturation well. We got a circuit ready in no-time and presto, it worked. I was quite encouraged.

2 days back, we had one more preterm born to a mother with severe eclampsia and he has also done well with the contraption.

Of course, you may say that cheap CPAP machines are now available. But with all the problems with electricity especially voltage fluctuations, simpler solutions such as these are a real blessing...