City doctors handle high-risk pregnancy deftly

ST CORRESPONDENT
Sunday, 10 February 2019

"We pulled through for 32 weeks with counselling, care and strict monitoring. In the 33rd week, we realised that the blood supply to the baby was being compromised, thus severely affecting the growth of the foetus,” said Dr Nayak.

PUNE: A 32-year-old woman has been suffering from a rare condition known as 'Takayasu's arteritis', which is an inflammatory disease of the arteries. However, after help from city-based doctors, she was able to deliver a child. She had previously undergone three abortions as pregnancy posed a major risk to her life.

“I have been married for the past seven years. For as long as I could remember, I have been suffering from this condition. There were times when I was always in pain, tired and daily activities became very difficult. Even after those abortions, I craved to have a baby of my own. I was prepared to go through any measures to have a child. When I conceived for the fourth time, I was overjoyed and requested doctors to help me do everything possible to keep this baby,” she said.

In Takayasu’s arteritis, the inflammation damages the aorta, the large artery that carries blood from the heart to the rest of the body and its main branches. The disease can lead to blockages or narrowed arteries or abnormally dilated arteries. It can also lead to arm or chest pain and high blood pressure and eventually to heart failure or stroke. Two-three such cases are reported each year per million people.

Explaining the case, Dr Vaishali Korde-Nayak, High-Risk Obstetrics Unit, Ruby Hall Clinic, said that when the patient decided to go ahead with the pregnancy, it was a challenge for them.

“From the very beginning, we knew that this case would be one of the rarest we have ever undertaken. Throughout her high-risk pregnancy, we had to monitor her blood pressure. There was a constant worry that blood supply to her kidneys or brain would get affected. We pulled through for 32 weeks with counselling, care and strict monitoring. In the 33rd week, we realised that the blood supply to the baby was being compromised, thus severely affecting the growth of the foetus,” said Dr Nayak.

She added that an emergency cesarean section was the best bet and the patient was taken in.
“With patients suffering from Takayasu’s arteritis, any kind of anaesthesia is a risk in itself. Our team consisted of obstetrics, physicians, critical care consultants, along with eminent cardiologists. Dr MS Hiremath managed this highly sensitive case with care and we successfully managed to deliver a healthy baby boy weighing one kilogram. Post operation, the baby recovered in the neonatal intensive care unit (NICU) for around 20 days while the patient was in the ICU,” said Dr Nayak.

Dr Sunita Tandulwadkar, Head of the Department of Obstetrics and Gynaecology and Chief of IVF and Endoscopy Centre, Ruby Hall Clinic, said that high-risk pregnancies are on the rise in India and the need for specialised and personalised care is essential to ensure the best possible outcome for both the mother and baby.

“We specialise in handling high-risk pregnancies. These range from pregnancies with swine flu, jaundice, chronic infections, HIV, autoimmune diseases to even cardiac conditions. We focus on the medical, social and educational needs of patients and their families,” said Dr Tandulwadkar.

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