In a remarkable medical achievement, a 33-year-old woman from Bengaluru has successfully given birth to a healthy baby girl after navigating a pregnancy fraught with multiple, severe complications. Timely and expert intervention at Vasavi Hospital enabled the mother to carry the baby to 37 weeks, defying significant odds.
A Cascade of Early Complications
The patient's challenging journey began early in her pregnancy. At just 16 weeks, a routine examination revealed a critical issue: her cervix was both short and had begun to open. This condition, known as cervical incompetence, meant the birth canal was preparing for delivery far too early in the second trimester, posing a high risk of miscarriage or extreme prematurity.
Simultaneously, doctors diagnosed another serious problem: severe early-onset fetal growth restriction (FGR). By the 25th week of pregnancy, it was evident the baby was not growing at a normal rate. Dr. Nisha Buchade, Obstetrician and Gynaecologist at Vasavi Hospital, explained that the situation was compounded by the discovery of a single umbilical artery, which likely contributed to the restricted growth. "Severe early-onset fetal growth restriction occurs in a small percentage of pregnancies," Dr. Buchade noted.
Strategic Medical Management Against the Odds
Faced with an open cervix at 16 weeks, the medical team performed an emergency cervical cerclage. This procedure involves placing a supportive stitch around the cervix to keep it closed. The cerclage held successfully, and after two weeks of prescribed rest, the patient could resume her daily activities.
The next hurdle emerged between 25 to 26 weeks, as the baby's weight dropped and amniotic fluid levels decreased. "We monitored the mother intensively using ultrasound and Doppler scans," said Dr. Buchade. The team provided targeted medicines and nutritional support to prolong the pregnancy as close to term as possible. Their efforts paid off when, by 37 weeks, the baby reached a weight of 1.9 kg and showed stable heart rate patterns.
Successful Delivery After Timely Intervention
The decisive moment arrived when an ultrasound showed a critically low level of amniotic fluid (anhydramnios), necessitating delivery within days. To aid the baby's lung development, steroid injections were administered. After 48 hours, an elective Lower Segment Caesarean Section (LSCS) was performed because the baby was in a breech position and due to the lack of amniotic fluid.
The outcome was a resounding success. "The caesarean section was uneventful. The newborn cried immediately after birth, fed well, and did not require any Neonatal Intensive Care Unit (NICU) support," Dr. Buchade shared. In a joyous conclusion, both mother and baby were discharged together on the third day post-delivery.
Dr. Buchade emphasized that this case is exceptional. The combination of severe FGR, low amniotic fluid, cervical incompetence, and a single umbilical artery typically results in pregnancy loss or extreme prematurity. The key to success was the early detection of cervical changes before symptoms appeared, allowing for a crucial emergency cerclage at 16 weeks and precisely timed medical management to support fetal growth until a safe delivery at 37 weeks.
