Chapter 18

Vijaya

@vallanki

Part: 18

Tanya and Kripa discussed about the abortion and her relation with Angad on Kripa's terrace after the party while Angad was seriously thinking how to come up with a favourable solution.

Angad wanted the baby at any cost. But had no guts to approach her parents. Misthy discouraged him to go forward with marriage as Naina might reject the proposal and force Kripa go for abortion. And then whatever Angad thought to save the child might go futile.

Angad prayed in his mind and cursed himself for not educating Kripa enough to understand his love. He called Doctor Cousin at midnight to inform her about his decision for saving the child. Doctor softly scolded him and asked to contact her after four days when Kripa came for next check-up. Angad went to bed but struggled for sleep till early hours.

Angad got call from the Doctor Cousin around 6 in the morning asking them to meet her immediately. Misthy and Angad went to her immediately. Doctor Cousin took them to another hospital where they met a research group led by an American researcher.

Doctor Cousin updated them on the way that she was under a research group who worked on artificial implanting, surrogating and saving premature babies. Angad's heart beat rose with her update and prayed for his favour.

"Hello! Ms. Sudarshana Desai!" Her fellow researcher Dr.Sachindra Bose received them.
Sudarshana introduced Angad and Misthy to them and explained the reason for them being with her.

Dr.Bose explained how pregnancy occurs and what the viability is.
Fertilisation, if successful, occurs within 1-2 days after ovulation in the distal fallopian tube. The fertilised zygote rapidly divides to form a cluster of cells called the morula, which then differentiates into the blastocyst, comprised of an inner cell mass (which forms the fetus, yolk sac etc.), and an outer trophoblast which forms the placenta and the membranes (gestational sac). The blastocyst continues to float freely while multiplying; and approximately 5-7 days after fertilisation, or between 19-21 days from the first day of menstruation, starts implanting (hanging), from the wall of the uterus. It continues to grow, though not visible to the naked eye.   Using TVS, the gestational sac is visualised by day 30. Cardiac activity inside the baby is demonstrable to the naked eye by day 35, i.e. 5 weeks after the first day of menstruation. The complete fetus is visible to the naked eye at 40 days (6-7mm).

Angad though did not understand the medical terms but eager to know how much chance he had to save the pregnancy. He interrupted Dr.Bose and asked if the fetus can be transfered or developed in vitro.

Dr.Bose laughed and told it's impossible till current situations and convincing the mother is the best way to save the child.
Pregnancy is typically broken into three periods, or trimesters, each of about three months.The first stage of pregnancy or the first trimester extends to 14 weeks or three and a half months. As the first trimester ends, the baby is approximately two to four inches in length. This is a developmental stage of pregnancy where all major organs have started to develop. The second trimester begins after three and half months of pregnancy, and comprises another of three months. This is a stage of extensive development of the baby. This is the stage where pregnancy starts showing on the mother.
In births during the 23rd or 24th weeks of pregnancy, the baby's fate is based on its viability — defined as the ability to survive, grow and develop normally, as opposed to merely showing signs of life. However, viability varies greatly between pregnancies. Nearly all pregnancies are viable after the 27th week, and almost no pregnancies are viable before the 20th week. The fetus can inhale at week 26, exhale and even cry. Eyes have completely formed, and the tongue has developed taste buds. Under intensive medical care the fetus has a over a 50% chance of surviving outside the womb.

Dr. Sachindra Bose explained how difficult and risky to save an unborn 6 weeks child.

Since Kripa was just diagnosed with pregnancy the chances of surviving the pregnancy were minimal. .
This is the challenge that the research group have taken now and trying to save the fetus under 26weeks of gestation. Though the chances are zeroes they will go forward if Angad accepts the challenge.

Angad looked at Misthy and Misthy was not at all inclined to his decision. Misthy feared when Naina came to know about all this mess she might sue them and they might end up in the jail. Angad ignored Misthy's decision and decided to go forward and spend money on it too. He convinced Misthy saying that anyway Kripa was not ready for the baby so he accepted the advice of the research group.

Dr.Bose requested Dr.Sudarshana to go for an ultrasound to find out the status of the fetus.

The beginning of pregnancy may be detected in a number of ways, including various pregnancy tests which detect hormones generated by the newly-formed placenta. Clinical blood and urine tests can detect pregnancy soon after implantation, which is as early as 6-8 days after fertilization. An accurate date of fertilization is important, because it is used in calculating the results of various prenatal tests. An early ultrasound can determine the age of the pregnancy fairly accurately.

Angad and Misthy took leave from the research group and came back to the hotel where they stayed. Angad went to Kripa's school everyday and watched her silently. Kripa's tension pained him. He took lot of struggle to control his desire of going to her and explain his love.

Kripa continuously bothered Tanya about her fears about delay on next visit to her cousin. At last the fourth day came and Kripa went for check-up. Dr. Sudarshana took ultrasound and found Kripa had longer pregnancy than she thought before. She conveyed the samething with the research group and Angad and on their advice she postponed the abortion plan for 10 more days.
Kripa was now totally devastated and started abusing Tanya for referring her cousin. Tanya was now helping Angad on Dr.Sudarshana's advice and consoled Kripa to be patient for just few more days and told her that her stomach was not going to be shown up so early. Innocent Kripa listened to her waiting patiently for the day.

Meanwhile the research group started their preparations to bring up the 3months fetus under incubator development.

Angad was all the time with the research group and keenly observed Kripa also. He was prepared to appear in front of her in unavoidable situation. Misthy was forced to help him.

Dr.Bose explained all the process they were going to experiment for the to-be-born baby. Angad was all the time praying for fate favor him.

Dr.Bose told that," My own experience in private practice, as I shall mention again below, is that infants of more that 32 weeks' gestation and weighing more than 2000 grams (4 pounds) need no incubator. Hence, it should be a rule in any institution to receive infants only who weigh less than this. There is no lower limit as to weight, for, as mentioned, even the smallest infant, weighing as little as 500 grams and of less than 25 weeks' gestation, with a length of 10 inches, are very rarely saved. An effort should be made in all cases. It should be remembered, however, that no institution will have a good mortality record which accepts many infants weighing less than 1200 grams". All the time he's warning Angad to prepare for worst.

The incubator chamber is situated on one side of a large room and is large enough and high enough for the nurses to enter. The frame work is made of iron and the two sides and top of glass. The floor of the room and incubator chamber are made of xylith. The heat is supplied by ordinary hot water tubes. The air is received from the outside and passes over the heating coils then over a vessel of water to give the required moisture. The air is filtered by a cotton filter. The heat is regulated by means of an increase or decrease of the ventilation. Electrical devices give warning that the temperature is going too high or too low. Dr.Bose explained his experiences and studies to Angad to make him ease and comfort with his situation and giving hopes for future.
A study of the premature infant the chapters on this subject in "Les Nourrison," by Pierre Budin, will be found especially valuable:Tha Nursling,Lecture 1:
Sterne, in "Tristram Shandy," quotes the following passage: --"The foetus was no larger than the palm of the hand, but the father, having examined it in his medical capacity, and having found that it was something more than a mere embryo, brought it living to Rapallo, where it was seen by Jerome Bardi and other doctors of the place. They found it was not deficient in anything essential to life, and the father, in order to show his skill, undertook to finish the work of nature and to perfect the formation of the infant by the same artifice as is used in Egypt for the hatching of chickens. He instructed a wet-nurse in all she had to do, and having put his son in an oven, suitably arranged, he succeeded in rearing him, and in making him take on the necessary increase of growth, by the uniformity of the external heat, measured of a thermometer, or other equivalent instrument."

Finally the day when Kripa supposed to go to the hospital Naina and Dilip has planned to go to Delhi on business development and they hired a nanny for help. Kripa thanked for favourable situation and took Tanya to the hospital.

Dr.Sudarshana completed the surgery under Dr.Bose supervision and took the fetus under care to their research centre in an incubator that developed for the baby's further life.

Angad was there all the time and felt very bad for Kripa's situation. Misthy consoled him to handle the situation carefully since he decided to go forward with the baby. Kripa spent two days in the hospital and sent home with care under Angad's supervision. Angad tempted to go inside Kripa's house since her parents were out of town. Misthy scolded him to control and not to give scope to kripa to know about everything. Tanya took good care of Kripa all the time till Naina came back.