Mangaluru, July 2025: In a landmark medical achievement, Father Muller Medical College Hospital (FMMCH) has successfully performed an in utero rescue of a fetus diagnosed with Non-Immune Hydrops Fetalis (NIHF)—a critical condition associated with high perinatal mortality, marking a new milestone in fetal medicine and maternal-fetal care in India.

Understanding the condition: What is NIHF?

Non-Immune Hydrops Fetalis is a severe fetal disorder involving the abnormal accumulation of fluid in two or more fetal compartments—such as skin, pleura, pericardium, and abdomen. Unlike immune hydrops, which stems from Rh incompatibility, NIHF arises from a variety of non-immune causes, including fetal anemia, infections, cardiac abnormalities, or chromosomal disorders. Swift diagnosis and skilled intervention are crucial, as the condition often leads to fetal death if untreated.

The case that changed the odds

At just 24 weeks of pregnancy, a woman was referred to the High-Risk Pregnancy and Fetal Medicine Unit at FMMCH with complaints of reduced fetal movements. A detailed ultrasound scan revealed severe fetal anemia and hydrops, with notable scalp and abdominal wall edema—hallmarks of life-threatening complications.

Confronted with a time-sensitive crisis, the multidisciplinary medical team decided on an emergency intrauterine transfusion (IUT)—a sophisticated and high-risk intervention that replaces fetal blood to correct anemia and reverse hydrops.

A rare and precise procedure

What made this case even more complex was the fetus’s anterior position and posterior placenta, making the typical approach through the umbilical cord insertion site unfeasible. The team instead opted for an innovative direct fetal approach—delivering the transfusion via the fetal portal vein, guided in real-time by advanced ultrasound imaging.

Fetal paralysis was induced to eliminate movement and ensure the precision and safety of the procedure.

Teamwork across specialities

This delicate life-saving intervention was made possible by a highly coordinated team, including:

  • Dr. Prathima Prabhu – High-Risk Pregnancy & Fetal Medicine Specialist

  • Dr. Muralidhar G.K. – Senior Consultant, Fetal Medicine & Intervention

  • Dr. Lenon D’Souza and Dr. Mandeep Sagar – Interventional Radiologists

  • Dr. Praveen Nayak K. – Consultant Pediatrician & Neonatologist

The antenatal journey was meticulously managed. Under the vigilant care of Dr. Prathima Prabhu, the mother continued to term and delivered a healthy baby through vaginal delivery. Postnatal care was provided seamlessly by Dr. Praveen Nayak, ensuring no complications arose.

Institutional leaders speak

“This exceptional achievement demonstrates the dedication and expertise of our clinical teams. It reflects our mission to bring cutting-edge care to those most in need.”
— Rev. Fr. Faustine Lucas Lobo, Director, FMCI

“Our teams continue to push boundaries in maternal and fetal care. This case is a shining example of teamwork, precision, and compassion.”
— Fr. George Jeevan Sequeira, Administrator, FMMCH

“Academic excellence, research, and patient-centred care are the pillars of our institution. This case exemplifies all three.”
— Dr. Antony Sylvan D’Souza, Dean, FMMC

“The coordinated efforts of our obstetrics, radiology, and neonatology departments made this possible. It’s a proud moment for the hospital.”
— Dr. Udaykumar, Medical Superintendent, FMMCH

Setting a benchmark in India’s fetal care landscape

This case illustrates the growing expertise in intrauterine fetal therapy in India. Through precise diagnosis, multidisciplinary collaboration, and advanced procedural capabilities, FMMCH has redefined the survival possibilities in a disorder once considered nearly fatal. It also places the institution among the few in the country capable of handling such high-risk fetal interventions.