Surviving nine months in the abdominal cavity outside the uterus, a baby girl has stepped into the world weighing a healthy 2.75 kg in Mumbra.
What was diagnosed as a case of double uterus with pregnancy in the left uterus turned out to be a rare case of full-term abdominal pregnancy for Mumtaz Shaikh (32).
It was only after the delivery that the doctors realised the baby had developed in the abdomen and not in the uterus.
Though there was very little hope of the baby and mother surviving the complications, the efforts of doctors at Kalsekar hospital in Mumbra helped save both lives.
When Shaikh had first done a routine check-up at Kalsekar hospital during her pregnancy, her medical condition and the health of the developing foetus was found to be normal. Shaikh regularly got follow-ups done for nine months before she was admitted to the hospital for her delivery on September 23 under the care of gynaecologist Dr Neerja Gupta.
All ultrasound reports had diagnosed Shaikh as having a double uterus with pregnancy in the left uterus.
Shaikh’s case was taken up for an elective, or planned, caesarean section on September 26 by a team of specialists, including Gupta. After the delivery, much to the shock of the operating team, no uterus was found on the left side, where the baby had developed.
The doctors realised they were dealing with a case of abdominal pregnancy, a condition in which the baby develops outside the uterus in the abdominal cavity and the placenta derives its blood supply not from the uterus but from vital organs in the abdomen.
According to the doctors, most modern modalities like ultrasound and MRI may fail to recognise this condition, as happened in Shaikh’s case.
“We were shocked when we realised that it was a complicated case of abdominal pregnancy,” Gupta said.
In abdominal pregnancy there is a very high incidence of maternal mortality as the mechanism of contracting the uterine muscle is absent. As a result, the open blood vessels are left to bleed torrentially.
If the placenta is left in the abdomen to avoid bleeding, there develops a very high risk of maternal infection that puts the mother’s condition in jeopardy.
In Shaikh’s case, when the doctors attempted to remove the placenta, they found that half of it was deriving its blood supply from the uterus and the other half from the intestine.
The doctors immediately performed an obstetric hysterectomy, or removal of the uterus along with the placenta even as there was profuse bleeding from the open blood vessels.
Shaikh lost as much as 1.2 litres of blood in a span of 10 minutes, which put her life in danger. “We had to immediately check the blood loss or we would have lost the patient on the operation bed,” Gupta said. “We used a special technique called cold saline haemostatic technique, wherein the abdominal cavity and the bleeding surfaces were packed with towels soaked in ice-cold saline water for 30 minutes and this reduced the bleeding considerably. The patient was kept in the ICU and was discharged on October 5 with her healthy female child weighing 2.75 kg.”
Shaikh’s mother Fatima said the family was very worried about both her daughter and the baby because of the complications in the pregnancy and praised the doctors for their efforts.
“The doctors at the hospital put in their best efforts to save both lives,” she said. “We are happy that no harm occurred to both.”
Shaikh, on a visit to the hospital for a post-delivery check-up, said she felt it was a miracle that she and her baby were alive. “It is by the grace of Allah and the efforts of the doctors that I and my baby are alive today,” she said. “I can still remember the day of the operation and I never believed that I would survive it. My daughter is healthy and my family is very happy now.”
Very rare for baby to survive
Dr Rekha Davar, professor and head of obstetrics and Gynaecology, JJ hospital, said: “Earlier, when there were no ultrasound facilities several such cases could not be detected until the day of the delivery. Nowadays, with the available medical technology, cases of abdominal pregnancy can be detected at the beginning of the development of the foetus. In this case, I believe the ultrasound could not detect the growth in the abdominal cavity. With such complications, delivering a healthy and live baby is very rare.”