Died Sep 10, 1977, 10:01 PM
Dr. Millard wrote:This is the story of Mary Elizabeth, born prematurely by Caesarian section... She had excellent medical care... but the medical considerations led to a birth at a time which was disastrous, not only for Mary Elizabeth, but also for her mother, who will never be able to have another child...
Mary Elizabeth was about two months premature and weighed one kilogram [2.2 lb.] when she was hastily delivered that night. The mother had reported that her movements were less well felt than they had been... the C-section was an emergency. There was not even time to inject the mother with cortisone to try to induced the enzyme which causes the lungs to produce surfactant. Unless this is done and surfactant can be produced, a two pound infant born prematurely by C-section is almost certain to have hyaline membrane disease.
Mary Elizabeth in fact had this disease, which used to be almost always fatal... Now that ventilators have been improved, and attention is paid to important matters such as the oxygen saturation and pH of the blood, survival has risen to 30% in neonatal intensive care units.
Mary Elizabeth seemed to be doing quite well for a few days, then her platelets feel to dangerously low levels... she began to bleed. What apparently had happened was that either hypoxia or acidosis had set in motion a process of internal clotting of the blood, and the platelets had been used up... Mary Elizabeth had a condition which is known as disseminated intravascular coagulation, because the components of the blood which are necessary for clotting are used up. Until they are replaced, the blood will remain fluid.
She was given a transfusion of fresh frozen plasma and packed red blood cells. The danger in being born too soon always lies in the lungs... The lungs became stiff and resistant to expansion because of the bleeding problem. [Treatment followed.] Finally... the ventilator was not able to oxygenate her body, and on September 10th, when she was eleven days old, she finally died.