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City hospital successfully treats pregnant swine flu patient

Team of doctors used extracorporeal membrane oxygenation technique for treatment; foetus safe

In a rare case, doctors at Fortis Escorts Heart Institute (FEHI), Okhla, treated a 30-year-old pregnant woman, Swapnil Mishra, who had tested positive for swine flu (H1N1 virus).

The case was extremely critical and complex as the foetus could not be delivered prematurely, but had to be protected from the virus while in the womb. Additionally, there was a risk of the mother developing bleeding complications and losing the unborn child.

Ventilator support

A team of doctors, led by Vineeta Goyal, Senior Consultant, Critical Care Department, took on this high-risk case and treated the patient successfully through ECMO (Extracorporeal membrane oxygenation).

“The patient was 24-week pregnant when she was admitted to the hospital with fever, persistent cough and shortness of breath. Her symptoms had worsened over the course of a day and her blood oxygen levels were extremely low. Her breathing became progressively laboured and she had to be immediately put on ventilator support. However, her condition continued to deteriorate. When the predicted chances of survival for both the mother and child fell considerably, patient’s family was given the option for ECMO [extracorporeal membrane oxygenation] machine which acts as a heart-lung bypass. It can support and perform the functions of the lung and the heart, individually and together,” noted a release issued by the hospital.

Complications, both maternal and foetal, were explained to the family. These included bleeding, intrauterine foetal death and spontaneous abortion.

The release noted that within one hour of ventilation, ECMO was instituted. “There was an immediate improvement in the blood oxygen levels of the patient. Since she had tested positive for the H1N1 virus, we had to treat her with antivirals such as ‘oseltamivir’.

A gynaecologist was consulted on a regular basis and repeated ultrasounds were done to ensure foetal well-being. After 15 days, the patient was successfully weaned off ECMO and her foetus was alive and thriving. She was discharged on the January 26. Both — mother and baby — remain healthy,” noted the release.

The doctors said that the key to success is early referral to an ECMO centre. Critical Care Department of Fortis Escorts Heart Institute takes pride to have saved both mother and foetus when survival seemed impossible.

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