Pregnancy is bliss but sometimes things can go awry. A Wockhardt Hospital team helped a 35 years old woman beat Covid-19 infection and given birth to a premature baby. The mother and baby both are doing well and have been discharged after spending 21 days in the ICU including 14 days on the ventilator.
Pregnancy is considered as one of the critical phases of a woman’s life. A woman goes through emotional, physical, and mental challenges while she carries on with her journey of becoming a mother. Hetal Gandhi, a housewife, with 7 months of pregnancy, was referred to Wockhardt Hospital after she complained of fever for two days. This was followed by a relatively asymptomatic phase for the patient. Then after 5 days, the patient started feeling breathless. This was followed by desaturation. She was shifted to Wockhardt Hospital Mira Road, for further management.
Dr Bipin Jibhkate, Consultant and Head Critical Care Medicine at Wockhardt said, “RT PCR test was performed on admission to confirm COVID-19. On admission, she was shifted to ICU and started on HFNC (high flow nasal cannula). With low immunity, there were multiple challenges in managing the patient in ICU. Her physiological needs were different from normal women. Pregnant females have a higher tendency for clotting, have high abdominal pressures, carbon dioxide levels goes low, they have a higher tendency to vomit.”
Her oxygenation could not be maintained even with the highest settings of HFNC. So, doctors decided to put the patient on a ventilator. “In such situation, generally normal patients are managed in prone position ventilation, but due to pregnancy that was not possible with this patient, so we decided to put her in the right lateral position,” said Dr Jibhkate.
Along with this, she was started on standard treatment of COVID, like anti-viral, antibiotics, steroids, and anticoagulation. She also had decreased urine, alternate hypotension and hypertension, very high heart rate of around 150/minute. “However, slowly she responded to the treatment and her ventilator requirement went down. After 7 days on the ventilator, we decided to put her on a percutaneous tracheostomy procedure. In her repeated COVID-19 test, she was turned out to be free from Coronavirus infection. Then, we shifted her to non-COVID ICU,” explained Dr Jibhkate.
However, because of the stress patient got premature rupture of membrane and went into labour at her 31st week of pregnancy.
Dr Mangala Patil, a Consultant Obstetrician, said, “As the patient has a tracheostomy, other complication might arise, it was decided that labour should be conducted in ICU. It was done under the supervision of Intensivists and neonatologists. It was very risky and unusual, as labour normally conducted in labour rooms.”
Ultimately, labour was conducted successfully and the mother delivered the baby and both were fine.
Dr Samir Shaikh, Consultant Neonatologist added, “The birth weight of premature Baby boy was 1560 grams. The new-born then shifted to NICU. Initially, the baby was unstable but later responded to the treatment. Ultimately, he discharged in stable condition.”
“I am elated and fortunate about the treatment I have received at this hospital. Our world came crashing down when I was tested positive for Covid-19. But, the doctors made sure that I deliver my baby safely, and now, my baby’s health has also improved,” concluded patient Hetal Gandhi.