First-ever repairing of uterine hole during pregnancy done on Andhra woman

The team discovered a sharp perforation in the patient's upper uterus, posing a unique challenge. Representative image: IvanaBoca/Shutterstock

Bengaluru: Doctors at Rainbow Children’s Hospital, Marathahalli in Bengaluru, in a first-ever reported case, repaired the uterine hole of a woman during pregnancy. The patient, a 22-year-old woman hailing from a remote town in Andhra Pradesh, was admitted to the hospital with severe abdominal pain and signs of shock during her sixth month of pregnancy. Her pulse was high and blood pressure was very low.

Her scans revealed alarming findings. There was lots of blood collection in the mother's abdomen, and there was little bleeding in the uterus also. However, the baby's heartbeat was fine and was not affected. Further, the diagnosis revealed uterine perforation and ovarian torsion (internal bleeding and damage to her uterine wall).

In a bid to save the baby and the mother, the team of doctors led by Meghana Reddy, at Rainbow went for laparoscopy, a minimally invasive surgical procedure used to examine the organs inside the abdomen.

The team discovered a sharp perforation in the patient's upper uterus, posing a unique challenge. The doctors, however, could not identify the reason behind the condition. It was the woman's first pregnancy and she had no prior surgeries.

"It is the first-ever case. We have not found a reason for the perforation as it looked like a sharp stab kind of perforation wound and the patient had no previous surgeries in the uterus or no trauma," Reddy, Senior Consultant, Obstetrics, Gynaecology and Laparoscopic Surgery, BirthRight, told IANS.

Typically, in cases of uterine perforation, pregnancies are terminated. However, the medical team opted for a multidisciplinary approach, deciding on laparoscopy and fetoscopic as well as laparoscopic suturing to repair the perforation and allow the pregnancy to progress.
"We did not want to lose the baby or the mother, so we decided on a multidisciplinary approach," Reddy said.
The intricacies of the laparoscopic procedure, compounded by the challenge of navigating limited abdominal space, underscored the expertise and resourcefulness of the medical team.

Through meticulous measures and timely action, they successfully controlled the bleeding and stabilised the patient's condition, offering hope for her and her baby. The woman went into labour at 37 weeks, and delivered the baby via normal birth. Both the mother and the baby are currently doing fine, the doctor told IANS.
Reddy said the case has been reported to various journals, including the American Journal of Obstetrics and Gynecology.
(With inputs from IANS)

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