Jan 31, 2021
Roopa Balan
Final year resident in Obstetrics & Gynaecology
Every woman loves a wonderful birthing experience be it either normal or cesarean birth.
Imagine, how a woman would feel if she is being told of having a grave condition where she can die on table where she is operated upon.
Imagine being sent away from one hospital to another, denying expertise or team in dealing with such an arduous bullet speed surgery.
God only knows how much that woman would have gone through having to travel all the way from vijayawada and roaming hospital to hospital and at last to land at our ER.
She was pregnant the third time, having lost one child already after birth.
She had both babies delivered by c.section.
Longing to have one more baby made her land up with a condition called placenta percreta, where the placenta wholly or partially is adherent on the uterus and invading the bladder like a tumour.
Adding to one grave condition, there were 2 other factors making the case even more challenging for any doctor to boldly operate upon her.
She was obese weighing 105kgs and had gestation diabetes mellitus on treatment with insulin.
We admitted her with lots of doubt and even more prayers.
Even a MRI to evaluate the extent of adherence was futile because of being obese.
Mustering all the courage, preparing to operate on her was an exciting experience for all the senior obstetricians and their residents.
Having had a handful of cases operated for the same condition at our facility and with the experience gained, we primed the family every single day to accept anything that might happen.
Then came the day before surgery, where all the junior residents were busy reserving blood for massive transfusion protocol.
I remember the night before where we were awake all night to prepare her.
We where confused whether it was a drill for a military operation or a wedding ceremony.
It was mixed with excitement and terror. Repeating verbatim every resident’s role during surgery , we passed the night.
Urologists , General surgeons , anaesthetists, Pediatricians, radiologists, senior and junior obstetricians, blood bank medical officer, almost 30 or more doctors worked together to save the mother and her baby.
The surgery lasted around 5 hours, having had to remove her uterus, repair her bladder, sending blood after blood, the operation theatre was filled with everyone having their assigned jobs.
Total of 16 products transfused, finally we made it, the patient and her baby made it.
Not everyone make it, we have seen deaths before our eyes, losing young mothers to this grave condition.
We think prevention plays a very important role, limiting family size, avoiding unintended pregnancies and abortions, avoiding c.sections without appropriate indication.
The western countries are more ahead and aware of this condition than us.
We hope awareness spreads in India too.
We hope we prevent deaths and gain more expertise in facing such cases.
Hoping the mother would share her experience very soon after her complete recovery.
Being aware of this complication early in pregnancy and adequate management at a higher center under multi disciplinary team can save lives !!