Bhubaneswar: In a “a rarest of the rare case’’, the experts of Department of Obstetrics and Gynecology of Kalinga Institute of Medical Sciences (KIMS) in Odisha capital helped a woman deliver one of the twins after 31 weeks of pregnancy while the first twin was still born after 23 weeks of gestation.
Pravati Beura, a 31-year-old mother from Kendupatna in Cuttack district, was admitted to KIMS with some complicacies following her IVF pregnancy. Pravati lost her first foetus, a female baby of 550 gram only, on October 29. Though she was having uncontrolled diabetes, obesity and hypothyroidism, the gynecologists took a huge challenge to save the other twin and kept the mother under strict antiseptic regimen, constant supervision and monitoring.
After 52 days of losing first foetus, she delivered the second foetus, a male child, weighing 1,370 gram on December 19. The baby, who is still in NICU, is doing exceptionally well along with her mother. This is perhaps the first of its kind in Odisha and “a rarest of the rare case’’, stated a release of KIMS.
From medical literature world over, it has been found that such high-risk twin pregnancies were managed in two or three cases in India and there was not a single instance from Odisha.
“The two gestational sacs in the mother’s womb in Pravati’s case was an added advantage for us due to a twin foetus and following the birth of still-born baby girl, we took all precautions and wanted to monitor the mother, the foetus and her parameters. The challenge was more as the mother had come from an outside IVF centre with a hope that we are the best managers during such cases in Odisha,’’ said Prof Jyotshnamayee Panda, Head of O&G Department.
“Another greater challenge was the placenta of the first delivery did not come out and some other complications occurred. But we did not give up and were successful in having natural delivery of the second foetus,’’ said Prof Pramila Jena, a leading faculty member of the Department, who carried out the delivery.
The faculty members of O&G at KIMS are of the opinion that the basic philosophy of patient safety and patient care has always been a top priority and hallmark of KIMS and with a proven track record majority of the high-risk pregnancies are thus, finding their ways to the O&G Department.
“We already have a High-Risk Pregnancy Monitoring Committee at KIMS. As the medical college believes in a collective decision-making process for better safety for the mothers and their children, active participation from O&G, Paediatrics (neonatologists) and support from NICU have made the process of handling the challenge of high-risk pregnancies, more smooth and technically valid,’’ explained Prof Panda.
As the team of neonatalogists of Dr Santosh Panda and Dr Manas Nayak are leading the neonatal backup process after the delivery, the baby and its mother, both are doing fine. “Just after the childbirth, the baby had some mild respiratory distress as it was only 1,370 gram. After oxygenation of 48 hours, the baby is fed through the nasal route. However, once it reaches 1,750 gram, it can be fed through its mouth and following observation both the mother-child can be released,’’ said neonatalogist Dr Manas Nayak.
