It is sad that I have to provide a disclaimer for this post but I (like many people in the medical field) find myself telling healthcare horror stories and pre-partum anxiety is not something I want to instill in any of my besties. If you do cheat and read please remember that healthy, happy babies are born all day, everyday and they are the norm, not the exception!
We've had several babies this year be admitted on a HIE protocol (hypoxic-ischemic-encephalopathy) and they are just very sad situations. These mom's typically have a completely normal pregnancy and something just flips during their deliveries (the baby gets stuck, heart rate drops . . . each story has a slight variation) and these babies have the dreaded "just don't look good" appearance when they are born. Some immediately have seizures, some have to have chest compressions, some just don't have any respiratory drive . . . again their stories all vary a bit. We admit these babies on a cooling protocol so that we can prevent more of their brain from dying (parts of it will die due to whatever caused their birth depression). So we take this little baby that was happily kicking and hiccuping and keeping mom awake all night jsut 24 hours ago and put them on ventilators and cool their body temperature for 48 hours and just wait to see how much we were able to save of their brain. Sometimes its a lot and these babies go on to live a relatively normal life, unfortunately the ones I've seen so far this year have had variable outcomes. They require a lot of close monitoring in the first few days to keep their blood stable (constantly giving transfusions), monitoring their acid/base balance, measuring if they had a bleed into their head, if their heart is still working properly, etc. It completely rips my heart out to see these nice, normal mom's coming to see their baby who they expected to have home already in their freshly painted room filled with baby toys and shower gifts and asking everyday if we think he/she will survive. :-( Once the baby has been cooled for 48 hours we warm them back up over a 12 hour period to see how they will do. Some do nothing, some have seizures, some wake up. The big benchmark is the MRI of the brain to tell us how much the brain was injured. It's the worst waiting game for a new (already highly hormonal) mother. We have a baby that will be warmed when I am on call next so say some prayers for a good outcome!!!
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