In rare occurrence, Sanpada woman delivers boy prematurely despite complications
With a history of three miscarriages, Sanpada resident Priti Iyer (36) was expecting twins with some trepidation this year. Her world had turned upside down a few months ago when, in her 15th week of pregnancy, one of them died inside the womb. With diligent care and close observation, doctors at Motherhood Hospital in Kharghar have managed to save the other one, and Ms. Iyer delivered a boy prematurely in July.
Ms. Iyer’s troubles began in her 13th week, when her cervix started opening from inside. A stitch was placed in the cervix to help it stay closed, and she was on medication and bed rest. Two weeks later, though, the stitch loosened up and had to be reinforced. “She was very closely monitored for cervical length and integrity of the stitch. She visited the hospital after 15 weeks with complaints of abdominal pain and vaginal bleeding,” said Dr. Anu Vij, consultant, obstetrician and gynaecologist at Motherhood Hospital. Dr. Vij said, “She was kept on conservative management but this time, she started leaking from one of the sacs. She had severe pain, which led to the tearing of the stitch and expulsion of twin one, which was a girl foetus.”
Ms. Iyer, however, made up her mind to be hopeful about the second foetus. A weekly injection and other infusions kept it safe in the womb. “It was a high-risk pregnancy, wherein we had to remove the dead foetus from the womb and continue with conservative management to save the second twin. Continuation of pregnancy after one twin is delivered or aborted is rare,” Dr. Vij said. The occurrence of such a delivery is 0.14 per 1,000 births, she said.
A 24-hour observation showed that the uterus was quiet after the first twin was expelled. “The Ultra Sonography (USG) showed that the second twin was doing well inside. So, the decision to put the cervical stitch again was taken. The patient continued the pregnancy till 25 weeks six days, after which she gave birth to a preemie (premature baby) weighing 840 gm and was shifted to NICU for further care,” Dr. Vij said. “Twin pregnancies come with a high risk and with problems related to the placentation, maternal age, medical problems, obstetric complications, and concerns about the twins’ growth. The death of one twin before birth leaves the survivor at high risk. The survivor twin can even suffer from cerebral palsy or other brain impairments. Hence, we had to take extra care to save the baby inside the mother’s abdomen.”
Baby Shakti, who was due on October 13, was born premature on July 5 with low birth weight and jaundice. Early feeding, kangaroo mother care and exclusive breastfeeding played a major role in his survival. Dr. Suresh Birajdar, consultant paediatrician and neonatologist at the hospital said, “Starting feeding within the first three days of his being born with exclusive breast milk helped him gain weight and boosted his immunity. Along with exclusive breast milk feeds, strict hand hygiene practices from the staff helped in keeping the tiny baby safe from life-threatening infections. The baby currently weighs 1.7 kg and was discharged from the NICU after 67 days of his birth.”
Ms. Iyer, who works with a multinational corporation, is on maternity leave, taking care of the baby and monitoring its ‘catch-up’ growth minutely. She is trained and confident enough to look after her baby. The baby’s proud father, Sangam Iyer, said, “Our baby is a fighter. He fought in the womb, and in the NICU. We hope he fights all his battles in a similar way and emerges a winner each time.”