What a beautiful story of hope, perseverance, and the importance of timely medical care! It's heartwarming to hear that the couple was able to fulfill their dream of having a baby, despite the challenges they faced during their previous pregnancies, thanks to timely intervention by Rainbow Children's Hospital.
It's also inspiring to hear about the important role that the doctor played in this journey. Dr. Gayathri BN's expertise in high-risk pregnancy and her ability to diagnose the rare Antiphospholipid syndrome (APLA) was crucial in ensuring the safety and health of both the mother and the baby.
Dr. Gayathri BNS (Consultant - Obstetrics and Gynecology, BirthRight by Rainbow Hospital, Bannerghatta Road) said, "Mrs. Kulkarni had her first pregnancy at 29 years of age. She had chronic hypertension and Type 2 diabetes. During pregnancy she developed Pregnancy induced Hypertension on top of her chronic hypertension and the doctors decided to terminate at six months due to high blood pressure. She got pregnant again after a few years. This time the baby had restricted growth and was not gaining weight inside the womb and the mother also had high blood pressure. Delivery was delayed in the fear of prematurity. Once the baby was born, it was kept in the NICU but the baby could not survive. The couple had given up hopes after trying two times and having a negative outcome."
During the third pregnancy, she consulted Dr. Gayathri BN who practices in BirthRight by Rainbow Hospital, Bannerghatta Road, Bengaluru and specializes in High Risk Pregnancy. Dr. Gayathri BN studied the situation and made some key decisions which saved the life of the mother as well as the baby.
After thorough examination and blood investigations it was found that the mother was diagnosed with a rare syndrome known as Antiphospholipid syndrome(APLA). This syndrome is a silent tormentor for pregnant women as there are no signs or symptoms. This is an autoimmune disease where the immune system creates antibodies that attack tissues of the body which results in blood clots.
"For pregnant women this creates issues in the blood supply from the mother to the baby. This was diagnosed as the cause for the previous miscarriages. As the patient was having a rare APLA syndrome, treatment was started in the beginning stage of the pregnancy. Blood thinner injections were given daily to prevent damage to the placenta. Patient was kept in close monitoring by frequent blood and urine tests to watch out for high blood pressure induced complications such as eclampsia(seizure in pregnancy). Her spiking blood pressure was controlled with antihypertensive medicines and utmost care was taken for preventing damage to maternal kidney, heart and other vital organs. Decision on timing of the delivery - The main features of Antiphospholipid syndrome is that the blood vessels get destroyed by the antibodies and the baby will not get blood supply for its growth and it will lead to growth restriction. In such a situation a decision needs to be made to grow the baby outside the womb by delivering it early. But the timing of this decision is crucial as vital development such as lungs, liver and fat insulation on the skin needs to be developed enough for the baby to survive outside the womb. Other wise the baby will have complications after delivery and also during its lifetime. In order to make the decision on when to deliver the baby, ultrasound scanning and color doppler scanning comes into play. Using these methods the blood supply and related oxygen supply is determined. If there is too little blood supply for the baby it can go into Hypoxia and the delivery needs to be done before hypoxia sets in. At the same time keeping the baby inside the womb as long as possible is also crucial. It is said that “one day in the womb of the mother is equivalent to 10 days of the baby in the NICU” regarding care, nutrition, and development of the baby. So it is important to buy as much time as possible within the mother’s womb. With close monitoring, finally the decision was made to do a cesarean section delivery of the baby at 28 weeks. A week earlier would mean the baby would be underdeveloped and a week later would mean that the baby will not have enough blood oxygen to make it to the NICU. The baby weight was 698 grams at the time of birth and it was immediately shifted to the NICU, where excellent care was provided for the baby", she said.
However, the baby development had its own challenges in the NICU which were excellently handled by NICU experts in ensuring that the baby is able to gain healthy weight. The parents were glad to take their baby home when it reached a milestone of 1300 gms. Now, the parents are elated to have a toddler walking around in their home fulfilling their dreams of having a baby. The baby has caught up with her age group in terms of physical and mental development. The parents were able to finally have a baby the third time due to correct diagnosis, timely decisions and excellent NICU care.
This case highlights the importance of timely and accurate medical care, especially in high-risk pregnancies. It also showcases the resilience of the human spirit in the face of adversity, and the power of hope and determination in achieving our dreams.
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