Recently a pregnant lady underwent successful Valve Replacement Surgery along with caesarian section in the same sitting at Sri Jayadeva Institute of Cardiovascular Sciences & Research.
According to Dr.C.N.Manjunath, it is a very rare complex clinical situation. Whenever such situation exists, the first objective is to save both mother and child. If mother’s life is at highest risk, then medical termination of pregnancy is recommended. Pregnant women with symptomatic heart disease will have very high maternal mortality, miscarriages and fetal deaths.
Smt. Pallavi of Kunikenahalli, Tumkur District was presented with 7 months of pregnancy and breathing difficulty. Initial cardiac evaluation revealed that she is suffering from Rheumatic Heart Disease and critical narrowing of the heart valve called Mitral Stenosis. Her heart valve was severely deformed with fibrosis and calcification.
Initially she was taken for Balloon Valvuloplasty as it is a non-surgical procedure which will relieve her symptoms without any much adverse effect on the foetus. Since the Valve Morphology was bad & Balloon Valvuloplasty did not give adequate results, she was taken up for Open Heart Surgery and Valve Replacement.
Always in this sort of situation, there is a clinical dilemma whether to do Open Heart Surgery first or Caesarian surgery first. Open Heart Surgery in pregnant women will increase the risk of intrauterine death of the foetus and also carries the risk of bleeding, the usage of blood thinning medicine (Heparin) is mandatory. Since mother was having acute breathing difficulty and impending death, Open Heart Surgery was conducted by Dr. P S Seetharam Bhat and his team.
During the period of Surgery, baby’s heart beat was monitored continuously. With the usage of new techniques and methodologies the child was kept alive till the Valve Replacement Surgery was conducted. Soon after the completion of Heart surgery, an alive female baby was delivered by Caesarian section which was conducted by Dr. Nirmala Bhat, Obstetrician & Gynecologist. Presently both the mothr and baby have recovered well and discharged in a stable condition.