22/11/2023
Every patient has a story...this is the story of my patient Mrs.N. ( photos taken with permission of patient and family )
She came to me in her 3rd month of pregnancy with a history of previous 2 cesarean sections but none of the babies survived. Both the babies died on day 2 - 3 of birth. Her blood group is RH negative which puts her at even more risk.
I investigated her thoroughly to find out the reasons for her previous 2 losses but couldn't find any reason per se. I monitored her closely with monthly follow up and some extra medicinal support. She followed up with me religiously and did not miss even a single appointment. At 28 weeks when we repeated her ICT it came out to be positive in high dilutions also. I monitored her biweekly with USG doppler for any signs of fetal anemia. Covered her with betnesol injection so that her fetal lung maturity is achieved. Finally at 34 completed weeks I planned her surgery. Her baby had already passed meconium in situ. But thankfully he cried at birth and did not need ventilatory support. But he has jaundice at birth which was very unusual.
The baby was admitted in NICU and within a day the bilirubin rose from 10 to 25. Baby was planned for exchange transfusion. Immediately after exchange transfusion, baby had a cardiac arrest and was put on ventilator but thankfully was weaned off within 3 days.
After all the ups and downs in her journey of pregnancy and post delivery, finally both mother and baby are happily going home at day 9.
I couldn't be more thankful to God for this patient and her happiness. But the things that I want to highlight in this journey are
1. Active monitoring of high risk patients.
2. Trust building between doctor and patient. I have to say this that when I decided to terminate the pregnancy at 34 weeks ,not even a single member of the family asked me why? They said - if u feel this is the best for her n baby then do it.
3. Its all a team effort- my staff, me and the pediatricians associated ( Dr. Sharad and Dr. Ravindra) worked really hard for this one. N all is well that ends well.
4. Last and the most important important thing - never lose faith in God. He is always next to you.
