Mangaluru: Government Lady Goschen Hospital in Mangaluru has successfully treated a 33-week pregnant woman who was in a life-threatening condition following severe antepartum haemorrhage, giving her a new lease of life after she was reportedly referred from a private hospital in Udupi district.
The woman had been admitted to a private hospital after experiencing bleeding before childbirth. An ultrasound examination revealed that the placenta was positioned across the passage through which the baby would normally be delivered.
The condition posed a serious risk to both the mother and the unborn child and required a complex surgical procedure involving multiple specialists.
High-risk pregnancy posed major surgical challenge
The patient’s condition was complicated by the abnormal position of the placenta, which increased the possibility of severe bleeding during delivery.
In such cases, the placenta can be closely associated with surrounding organs, increasing the risk of injury to the urinary bladder, small intestine and large intestine during surgery. In severe cases, removal of the uterus may become necessary to control life-threatening bleeding.
Doctors said the loss of around three to four litres of blood can occur during such procedures, making the management of the patient particularly challenging.
The condition also carries a high risk to the mother’s life, requiring careful planning and the availability of specialists capable of managing complications involving multiple organs.
Life-saving procedure at Lady Goschen
Lady Goschen Hospital has been implementing a specialised approach to such high-risk cases for the past one-and-a-half years.
The procedure was conceptualised as a special initiative by hospital medical superintendent Dr Durgaprasad M R, with the objective of minimising blood loss and ensuring that the patient receives immediate specialist care if complications arise.
Since several organs may be affected during the surgery, specialists from the relevant departments, along with super-speciality experts, are called to the operation theatre in advance.
The presence of the specialists allows the surgical team to respond immediately if an injury occurs to the urinary bladder or other organs during the procedure.
The approach also enables the team to manage severe blood loss and other complications without losing valuable time in arranging specialist assistance.
KMC specialists play key role
Prof Dr Nikhil Shetty of the KMC Department of Obstetrics played a key role in making timely decisions during the surgery and served as the chief obstetric surgeon.
Senior resident Dr Susham Shetty, assistant professors Dr Gagan Deep Kaur and Dr Prithvi Shenoy, and junior resident Dr Tanvitha assisted during the procedure.
The coordinated effort of the obstetrics team and specialists from other departments was crucial in managing the high-risk surgery.
The procedure required the involvement of multiple medical teams because of the possibility of injury to organs surrounding the uterus.
Four hours of surgical care
KMC specialists Dr Pramod, Dr Meet and Dr Shivanand provided continuous surgical care for around four hours.
During the procedure, the urinary bladder had sustained significant injury. The team carried out a specialised repair and provided what the hospital described as a new form of pre-treatment to the completely injured urinary bladder.
The intervention was aimed at restoring the affected organ while simultaneously managing the primary obstetric emergency.
KMC anaesthetist Dr Shilpa continuously monitored the patient’s vital parameters throughout the surgery.
Continuous monitoring was particularly important because the patient was undergoing a prolonged and complex procedure while already being at risk from substantial blood loss.
Premature baby receives emergency care
The baby was born prematurely at 33 weeks and required immediate medical attention following delivery.
Before the premature baby was shifted to the neonatal department, paediatrician Dr Aarushi provided the necessary emergency care.
The timely intervention ensured that the newborn received initial stabilisation before being transferred for specialised neonatal care.
Nurse Deepa also provided assistance during the procedure and supported the medical team throughout the treatment.
Coordinated care helps save mother
The case highlights the importance of coordinated care in managing pregnancies complicated by severe bleeding and abnormal placental positioning.
Rather than relying on a single speciality, the treatment involved obstetricians, surgeons, an anaesthetist, a paediatrician and nursing staff working together.
The advance presence of specialists in the operation theatre allowed the team to address complications immediately, particularly those involving the urinary bladder and other surrounding organs.
Lady Goschen Hospital’s initiative over the past one-and-a-half years has focused on preparing for such emergencies before surgery begins, thereby reducing delays at a time when every minute and every drop of blood can be critical.
The successful treatment of the 33-week pregnant woman demonstrates the role of multidisciplinary medical care in handling complex maternal emergencies and providing timely treatment to patients in critical conditions.