neonators

Important People of Medicine: Virginia Apgar

If you’ve ever had, or been around a baby that was born in a hospital, Dr. Apgar’s name probably sounds familiar. An anesthesiologist and teratologist (one who studies abnormalities of physical development), Virginia Apgar is most well-known for the "Apgar score" - a rating given to infants at 1 and 5 minutes after birth, which is often a determining factor in whether or not the baby needs to remain in the hospital after birth.

Dr. Apgar was the first female doctor to receive professorship at Columbia University medical school, and her work in teratology during the rubella pandemic of 1964-65 led to her outspoken advocacy for universal vaccination against that disease. Though it’s often mild and annoying above all else in healthy people, when pregnant women contract rubella (also known as German measles), the rate of deformity and disability of their children skyrockets. It can even cause miscarriage.

Virginia Apgar also promoted universal Rh-testing among pregnant women. This test shows whether a woman has a different Rh blood type than her fetus, because if she does, she can develop antibodies that can cross the placenta and destroy fetal blood cells. This can cause fetal hydrops and high levels of neonatal mortality, but can be prevented by administering anti-RhD IgG injections to the mother during pregnancy, so that she does not develop a sensitivity (and subsequent antibodies) to her baby’s blood type.

Though Dr. Apgar never married or had children of her own, she saved the lives of countless babies and streamlined many medical considerations of neonatal care, resulting in more effective medical treatment. She studied and promoted the prevention of premature births and causes of fetal deformity. She worked for March of Dimes and taught thousands of students. Her influence in the obstetrics and neonatology fields cannot be overstated.

Don’t you just like, I don’t know… hold babies all day long?
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Yes.

I hold a baby when I hand him to his mother for the first time, three weeks after his birth date.

I hold a baby when teaching a new mother how to breastfeed her child.

I hold a baby to feed him, to rock him to sleep, to bathe him and bundle him.

I hold a baby when morphine and walking the halls 24 hours a day are the only things that will quiet him down while he’s withdrawing from the illegal drugs his mother took.

I hold a baby’s arm still when my fellow nurse inserts an IV.

I hold a baby’s head still while we bag oxygenated air back into his tiny lungs.

I hold a baby when he has no family to hold him.

I hold a baby when he takes his last breaths because his parents didn’t make it to the hospital in time.

I hold a baby when I’m placing his lifeless, tiny hands in plaster to make a keepsake for his parents… because there is no baby to hold anymore.

Yes.

I hold babies all day long. 

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Your vocabulary lesson of the day is “To be born in the caul”

We say that babies are born in the caul when they are born with their membranes intact surrounded by their amniotic fluid. It’s pretty uncommon for it to happen much in hospitals now because many nurse midwives and obstetricians break laboring women’s water to try to speed along labor. I have seen a few at home births, in fact the first baby I caught as an apprentice midwife was a baby girl born in the caul at midnight on a full moon. It was a pretty special birth! <3 This little one seems to have had a surgical assist into this world. 

And now you’ve had a peek into the fetal world from which we all originated and a little lesson in natural childbirth vocabulary. 

Inflatable baby incubator wins James Dyson Award

A prototype inflatable incubator for prematurely-born babies has been picked as the international winner of this year’s James Dyson Award.

Mom costs a fraction of the price to make than commonly-used alternatives.

The project’s inventor - Loughborough University graduate James Roberts - said he hoped the final product would be used in the developing world.

One expert said it should be a good stand-in so long as the babies using it were not too premature.

Mr Roberts said that he had begun work on Mom as part of a final year project inspired by a TV documentary.

"I was watching a Panorama programme on BBC about Syrian refugees, and they had a segment about how there are loads of premature kids dying because of the stresses of war and specifically the lack of incubators out there and the infrastructure to support them," he recalled.

"I thought there has to be a way to solve that."

He added that the £30,000 award meant that he could continue work on the machine, which he now hopes to bring to market by 2017. 

(More on BBC News)