A team of doctors from Motherhood Hospital Kharghar, led by Dr. Shaifali Patil, Consultant Obstetrician and gynecologist, and Dr. Suresh Birajdar, Consultant Neonatologist, and pediatrician, successfully assisted 35-year-old Punit Shaw in delivering a baby boy weighing 1.5kg.
Shaw's pregnancy was complicated due to cervical insufficiency, making it critical and high-risk. The baby received NICU care for 24 days to ensure his well-being and development.
Punit Shaw, an engineer, and her partner, who serves in the Merchant Navy, were overjoyed with the news of their first pregnancy. However, their happiness turned to concern when cervical insufficiency was discovered at 20 weeks, leading to a dilated cervix of 2 cm. When cervical insufficiency is present, the uterus is unable to sustain a pregnancy until full term. Many second-trimester miscarriages and neonatal deaths are caused by cervical incompetence. In the second trimester, if the membranes prolapse in the vagina due to cervical incompetence it can be technically very difficult for the gynecologist to push the membranes back in the cervix and apply cerclage to prolong the pregnancy. Following thorough counseling, the team of doctors proceeded to perform a cervical cerclage, physically closing the open cervical os.
At 20 weeks of gestation, the patient underwent cervical encirclage, a surgical procedure in which a stitch is placed around the cervix to provide support and prevent premature opening. However, at 28 weeks, it was discovered that the cervical OS (opening) was open, indicating a potential risk of preterm labor. In response to this finding, the doctor advised the patient to undergo bed rest to reduce physical activity and minimize stress on the cervix. At the 30th week patient went into labor with pain in the abdomen with a breech presentation so a combined decision of LSCS was taken.
Dr. Shaifali Patil, Gynecologist and obstetrician, at Motherhood Hospitals, Kharghar said, "Immediate decision-making is crucial in high-risk pregnancies like Shaw's. Detecting and addressing complications such as cervical insufficiency early can prevent premature birth or miscarriage. Regular monitoring and follow-up are necessary to assess the effectiveness of treatment. In Mrs. Shaw's case, a second cervical stitch was performed promptly when the initial cerclage did not work. Strict bed rest and close monitoring are recommended, with regular sonography to track progress and adjust the treatment plan. Emotional support and counseling with patients and their families are crucial throughout the process. Overall, immediate decision making, and skilled care can ensure a safe and successful pregnancy outcome in high-risk cases."
Even if the baby was in a breech position, the team ensured the safe delivery of the baby and the safety of the mother’s health. Given the premature birth at 30 weeks and a weight of 1.5 kilograms, the baby received specialized care in the Neonatal Intensive Care Unit (NICU) for respiratory distress syndrome (RDS) and overall growth and recovery.
Dr. Suresh Birajdar, Senior Consultant and neonatologist at Motherhood Hospitals, Kharghar said, "The baby experienced prematurity condition of respiratory distress syndrome (RDS) and was given CPAP support. Throughout the baby’s recovery, we ensured that the mother practiced Kangaroo Mother Care (KMC), involving skin-to-skin contact. KMC provides essential benefits for the preterm baby, helping regulate body temperature, improve respiratory stability, boost the immune system, facilitate breastfeeding, and foster emotional bonding. After 3 weeks of receiving specialized care in NICU, the baby boy's weight increased to 2 kilograms, and both mother and baby were discharged from the hospital, prepared to commence their new journey together."
The story of Shaw exemplifies the challenges associated with such high-risk pregnancies and the risks of preterm birth. Through timely interventions, medical expertise, and support, her pregnancy was successfully managed, resulting in the birth of a healthy baby boy. Furthermore, the implementation of Kangaroo Mother Care proved effective in promoting bonding and aiding the recovery of the preterm baby.
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