NEW DELHI: Several doctors’ associations today jointly issued policy guidelines for the management of premature babies at the hospitals to resolve the dilemmas patients and doctors face in such cases.
On November 30, a pre-term baby was wrongly declared dead by doctors at the Max hospital in Delhi’s Shalimar Bagh and handed over in a plastic bag but was found alive while his “body” was being taken for the last rites.
The baby who was born as a twin at 23-week pregnancy, however, later died at a Pitampura hospital. Following the outcry against the shocking case of medical negligence by Max, Shalimar Bagh, the Delhi government had cancelled its license.
While issuing the policy guidelines today, representatives of the Indian Medical Association, Indian Association of Paediatrics and the National Neonatal Forum of India said that the guidelines were being laid down for the benefit of doctors and parents as there are no government rules for managing such patients.
“Viability is defined as more than 28 weeks and more than 1 kg. Anything less than that level of treatment has to be decided on case to case basis based on chances of intact survival, informed consent, taking into consideration social determinants of health. Basic care should not be compromised,” the guidelines said.
They also mentioned that the issue of initiation of resuscitation for extremely premature babies is a grey area. “When the foetus is 28 weeks or more, all efforts should be made to ensure that it survives, between 24-28 weeks, resuscitation can be done and till 24 weeks, the pregnancy can be terminated as is being suggested by various organisations and is under review by the government,” they said.
IMA president K K Aggarwal said that need for issuing the advisory felt as the association had received hundreds of calls from doctors in the country on how to approach management of such babies following the Max row.
“We therefore wanted to issue a standard operating procedure that can be followed safely. It will allow doctors to decide how to go ahead and also help parents make choices,” he said.
IAP president Anupam Sachdeva said that the guidelines were based on the best practices adopted worldwide and the World Health Organisation recommendations and stressed that the Centre should turn them into protocols to be followed by hospitals.