Doctors deliver baby of woman on ventilator hit by swine flu, pneumonia

Doctors deliver baby of woman on ventilator hit by swine flu, pneumonia
Barely conscious and nine months pregnant, Bhagyashree went into labour after being admitted to KEM’s ICU. Doctors who helped her deliver a healthy boy say this is the first childbirth involving a swine flu patient.

Last week, when doctors in Kalyan told Hanumant Agari that the condition of his daughter Bhagyashree - nine months pregnant and experiencing breathing difficulty -- had taken a turn for the worse and recommended she be shifted to a hospital in Mumbai, Agari, 56 and a driver by profession, immediately arranged for an ambulance to get her to KEM Hospital.

After she was admitted in ICU late on March 16, doctors found that Bhagyashree, 21, had bacterial lung pneumonia, and further tests revealed she had also contracted swine flu as well leading to Acute Respiratory Distress Syndrome (ARDS).

The H1N1 virus was aggravating the ARDS, and doctors had already told him that chances of saving both mother and child were dwindling. Her breathing had become erratic, forcing doctors to put her on the ventilator. Swine flu was confirmed on March 17, and by afternoon, Bhagyashree began experiencing labour pains.

With time running out, medical ICU (MICU) head Dr Nitin Karnik called in Dr Shashank Parulekar of the gynaecology department for an urgent meeting. After some deliberation, it was decided to carry out the delivery in the MICU – something that is rarely done, especially when the mother is on life support and semi-conscious.

“It was a challenging situation. The mother should be conscious during the delivery, as otherwise the blood pressure could fall and prove deadly for the infant. Other vital parameters too could suffer. In such situations, it is difficult to save both mother and child. It was a big risk.

We couldn’t shift her to the labour room as she had swine flu, so we outfitted all MICU patients with masks. Given her condition, a Caesarian section was out of the question, so we went in for a normal delivery in the ICU itself,” Karnik said.

Working together with a sixmember gynaecologists’ team led by Parulekar, doctors successfully navigated what proved to be a difficult childbirth that lasted several hours before delivering a healthy baby boy weighing 2.5 kg, around 8.30 pm on March 17.

“It’s the first instance where a woman with ARDS and swine flu and on life support successfully delivered a healthy baby. There was a chance of her going into septic shock. It was a tough delivery, but the team effort paid off,” Karnik added.

Agari said his daughter had married Manchar-based Vikram Waikar last year, and this was their first child. “She came to visit us in Kalyan on March 12, and soon began complaining of breathlessness. Local doctors could not help, so I rushed her to KEM Hospital in Mumbai. I had no idea she was in such bad shape, I was so worried,” he said.

Karnik said while Bhagyashree is still on the ventilator, her condition is improving. “She is taken off the ventilator at regular intervals to get her to breathe on her own, which she is managing to an extent. The infant is doing well and is being cared for by nurses. He is now being fed from the hospital’s milk bank,” he said.