In yet another example of clinical excellence by Apollo Hospitals, Apollo Cradle, the premier birthing center, today showcased its expertise in handling high-risk pregnancies by helping a woman with not one but two rheumatological complications deliver a healthy baby boy.
Mrs Shyamala approached Dr S Ramakrishnan, Senior Rheumatologist, Apollo Hospitals, Chennai with a history of previous foetal loss in her first pregnancy. Examination of her records revealed that she had a combination of two Rheumatic diseases, generally associated with bad pregnancy outcomes. The two diseases were Primary Antiphospholipid Antibody Syndrome and Neonatal Lupus, which have always been a challenge to Rheumatologists in terms of management.
Speaking about the condition, Dr S Ramakrishnan said, “Some women during pregnancy have substances called Anti-Ro and Anti-La antibodies in the maternal blood, which cross the placenta and damage foetal conduction system and heart muscles. This damage results in complete heart block or heart failure ultimately leading to foetal death. This condition is called neonatal lupus.”
Mrs Shyamala had another coexistent Rheumatological disease named Primary Antiphospholipid Antibody Syndrome, which is also associated with increased risk of foetal demise, due to risk of blood clot during pregnancy. The blockade of blood supply to the foetus results in foetal demise.
“We have seen that administering a combination of blood thinners and intravenous immunoglobulin at appropriate frequencies can prevent foetal death and ensure successful delivery. Mrs Shyamala was administered intravenous immunoglobulin on the 12th, 15th, 18th, 21st and 24th week of pregnancy and underwent frequent echocardiography to detect foetal heart block and there was no evidence of heart block in the test done,” Dr Ramakrishnan added.
She was followed meticulously by Dr Kondammal, Senior Consultant Obstetrician at Apollo Cradle. The pregnancy went through successfully and a healthy male new born was delivered by Lower Segment Caesarean Section (LSCS) on the 37th week of her pregnancy.