Woman with history of bypass surgery delivers healthy baby at Nagpur’s AIIMS
Nagpur: We live in an age of amazing medical breakthroughs, advances so remarkable. Doctors really can do wonders!
According to media reports, at Government Medical College and Hospital (GMCH), a teenage boy regained consciousness after remaining on mechanical ventilator support for 107 days. The 15-year old boy was taken off the ventilator and shifted to the general ward from the ICU of Medicine Department on November 12. The kid patient is now on two litre oxygen and would be gradually able to breathe on his own, said Associate Professor Dr Milind Vyawhare, who led the team of doctors. Dr Prashant Patil, Head of the Department, said that the case is one of the success stories of the Medicine Department.
The GMCH team comprised Dr Vyawahare (ICU In-Charge), Dr Archana Aher, Dr Abhishek Pande, Dr Riya Saboo, Dr Shrijan Khandelwal, Dr Suraj Hiwarkar, Dr Saurabh Meshram, Dr Tushar Khadase, Dr Puja Borlepawar, Dr Pradnya Gavit, Dr Saurabh Sharma, Dr Shital Bharsad, and Sister In-Charge Geeta Kannake.
The media reports further said that the teenage patient hailed from Gadchiroli. He was admitted to a local hospital following a fever due to reaction of drugs given for epilepsy treatment in July. The fever went out of control and the boy developed blisters all over his body, besides breathlessness. He was referred to Nagpur’s GMCH and brought to the hospital on July 29.
According to Dr Vyawahare, the kid patient was denuded as his skin vanished due to merging of blisters. This is called Stevens Johnson Syndrome (SJS)/Toxic Epidermal Necrolysis (TEN, a skin disorder) overlap. He also had mucosal lesions (inside the mouth), said the doctor. Since the skin, which protects from external organisms, peeled off, it turned a source of entry for organisms leading to infection (sepsis). “The patient developed sepsis which caused multiorgan failure. Lungs were affected due to ARDS (Acute Respiratory Distress Syndrome) and he was unable to breath as the lungs got swollen. His kidney got injured and BP was low,” said Dr Vyawahare adding the patient also had thrombosis in cerebral venous sinuses and was having continuous convulsions.
Dr Vyawahare further said that the anti-convusion drugs could have aggravated SJS. So, they had limitations. They managed the patient on ventilator and controlled sepsis, ARDS, convulsions and renal functions. Before this, the doctors had given prolonged ventilator support to many patients for multiorgan dysfunction almost up to five months but those patients could not be saved. “This time, we saved this patient and successfully weaned him off from ventilator support after 107 days with normal functioning of his vital organs,” Dr Vyawahare stated.
Another medical feat at AIIMS:
A 47-year old woman, a patient of severe heart disease with a history of bypass surgery was found unaware of carrying a 9-month old baby when she reached AIIMS in Nagpur in the last week of October with complaints of abdominal pain and fullness. Doctors were in a surprise as the ultrasound revealed the woman’s first prenatal sonography since she conceived. Childless for 18 years, the couple had lost hopes of becoming parents. They never imagined that the pain the woman was going through for the past nine months was due to pregnancy.
The team of AIIMS doctors provided multi-disciplinary care with cardiologists, anaesthesiologists, neonatologists and obstetricians to conduct this unique experience of managing a patient who had undergone a cardiac bypass surgery and still delivered a healthy baby. Such a case is rarely reported in literature, claimed the AIIMS doctors.
According to reports, the 47-year old woman had a pregnancy almost 17-years ago. The pregnancy ended in the fifth month. Since then, she never got pregnant. Later, she developed a heart disease and had to undergo bypass surgery four years back. She was on treatment for hypertension and diabetes. “After tests, we decided to go for an elective cesarean,” said Dr Suchita Mundle from the team of obstetricians at the AIIMS. The team also comprised DR Anita Yadav and Dr Neha Gangane. Cardiologist Dr Gunjan Ghodeshwar took care of the heart condition of the patient.
C-Section was done on October 27 and a healthy girl weighing 3.2 kg was born. The mother and baby were discharged recently with certain guidelines to be followed.
According to neonatologist Dr Nishant Banait, many facts were unknown about the baby. Throughout the pregnancy, the mother was taking medication for her heart condition and diabetes which are known to be harmful to a growing fetus. Fortunately, the baby was born with a good size and without malformations. However, there was a hick-up when the baby dropped its sugar levels within the first 24 hours, which was taken care off swiftly by the NICU team, said Dr Banait.
One of the challenges the AIIMS doctors faced was continuing the mother’s medication while she continues to breastfeed her baby. The team of doctors had a discussion with the baby’s parents and informed them about the benefits of breastfeeding the baby against the chances of harm caused by the medication (a low probability) the mother is receiving. Subsequently, the baby was allowed to breastfeed.
The AIIMS Director and CEO Maj Gen Dr Vibha Dutta said that it was teamwork that handled such a rare case. “AIIMS is committed to provide safe maternity and child care in a most modern and well-equipped birthing centre. AIIMS is starting an ART Centre to take care of the needs of infertile couples. The Centre will provide services like embryo culture, embryo transfer and intracytoplasmic sperm injection,” the Director said.