PUNE: Timely intervention by the team of doctors from Ruby Hall Clinic saved the life of a 32-year old woman who had taken pills to terminate her third pregnancy without consulting any gynaecologist. This led to danger to her life, but the doctors saved her.
The woman after conceiving was bleeding and a local physician recommended medication to terminate the pregnancy. However, after a few days, she started vomiting and having loose motions along with severe stomach pain. This was followed by a series of blackouts.
She was shifted to Ruby Hall Clinic. Dr Tanima Baronia, Senior Intensivist - Intensive Care Unit (ICU), Ruby Hall Clinic said that the patient’s breathing was very rapid and she was going pale when she first saw her. “Her blood pressure was not even recordable. The patient required to be resuscitated. At first, it seemed like she probably had an abnormally placed pregnancy as she had heavy internal bleeding. Her sensorium had also started dipping, that’s when arranged for 10 units of blood components from the blood bank. We put her on a ventilator to support her failing organs,” said Baronia.
“At first glance, I was confident the patient had a uterine rupture and would require emergency surgery,” said Dr JP Rath, Emergency Obstetrician, Ruby Hall Clinic. Uterine rupture is associated with clinically significant uterine bleeding, foetal distress, expulsion or protrusion of the foetus, placenta or both into the abdominal cavity, and the need for prompt uterine repair or hysterectomy. The risk factors for rupture include previous cesarean sections, multiparity, malpresentation and obstructed labour, uterine anomalies, and use of prostaglandins for induction of labour.
“A laparotomy confirmed a ruptured uterus. The patient also had an IUD (intrauterine device) which had extruded into the abdomen. She had lost over 2.5 litres of blood. The patient underwent an emergency obstetric hysterectomy (surgical removal of the uterus) and she was then shifted to the ICU post surgery,” said Dr Rath.
Dr Prachee Sathe, Director - Intensive Care Unit, Ruby Hall Clinic said, “We were worried that her kidney may give up or she might go into multi-organ failure or even respiratory failure. She was shifted to ICU after the surgery and within 24 hours we could extubate her and the next day she was in a condition wherein she could be shifted out of the ICU. Within five days, she could go home,” said Dr Sathe.
Dr Rath said “The patient was given an MTP tablet (pill to terminate pregnancy) in the 13th of 14th week which was too late. More importantly, these tablets were not recommended to those patients who have had a c-section, which was the case with this patient. Secondly, patients who have conceived must visit the gynaecologists and not adhere to tablets given by general practitioners. If the patient would have come in even 30 minutes late, we would have lost her,” added Dr Rath.
The team of doctors were Dr Prachee Sathe, Dr Tanima Baronia, Dr JP Rath, Dr Arun Kumar Parathody, Dr Nipun Gupta, Dr Jyoti Punamia and Dr Avadhut Bodamwar.
