Time and time again, PSG Hospitals has proven to be a leader in delivering 24/7 quality care even during the unprecedented situations. Recently during this second wave of covid-19 pandemic, PSG Hospitals has taken all measures to give its patients a great sigh of relief from pain, by giving its best treatment and care.
The Fetal Medicine team, the Cardio thoracic team, the interventional radiology team have all risen to the occasion when their services were needed urgently by respective patients, and the healthcare personnel have changed the patients’ life despite the challenges that were ahead of them.
PSG helps Fetus see the light of day!
Nature and providence remain mysterious to us. Beyond certain limits, everything seems to be a puzzle. It is a fact that no mother will harm her own child but what if she has no clue of that, and unknowingly affected her own baby?
That is what happens to pregnant mothers whose blood’s Rh factor is different from their fetus. If not managed in time, then the fetus may become seriously affected and even be stillborn.
Two fetuses were in need of the Fetal Transfusion and their pregnant mothers were brought to PSG at different time periods. The hospital’s Fetal Medicine Team has ensured the survival of the fetus and it has seen the light of the day now. One mother has delivered her child safe and sound and the other is expecting her delivery soon while receiving treatment from the hospital.
Dr.Lalitha, Fetal Medicine Consultant, PSG Hospital who treated the mothers shared lots of valuable information related to this procedure
What is Rh Factor?
The surface of red blood cells contains markers that the immune system can recognize, and one of these markers is the Rh factor. We all have different blood groups like A, B, O and AB but it is the Rh Factor that gives them the positive and negative sub-groups.
A person whose blood contains the Rh factor is Rh-positive; a person whose blood does not contain the Rh factor is Rh-negative. So when a person’s blood type is A, and he/she has Rh factor in the blood then that person’s blood group is ‘A +ve’. In case, the Rh factor is absent then it will be ‘A –ve’
When will it be a trouble to fetus?
When the mother’s blood group is positive but her fetus’ is negative, then that is where the problem starts. The mother will start to produce antibodies in response to the baby’s different red blood cell characteristics. These antibodies will impact the RBCs of the baby and can cause anemia which in turn may lead to heart failure of the fetus or in worst cases, death.
How to identify babies at risk?
All Rh negative mothers are checked for the presence of antibodies to Rh factor in their blood during pregnancy. If antibodies are found, in order to find out whether the fetus is at risk, earlier its blood or amniotic fluid was collected and tested. But now, through the use of an ultrasound scan, the baby’s blood hemoglobin level could be predicted by assessing the fetal blood circulation, and through that the experts will find whether the baby is developing symptoms of anemia.
How can the baby be saved?
Once it is confirmed that the fetus is anemic, then it is important that Fetal Transfusion procedure is done. This is a very crucial procedure for survival of the fetus. The procedure is done under local anesthesia under continuous ultrasound guidance.
Blood is transfused to the baby inside the mother’s womb through the umbilical cord. The baby’s haemoglobin is checked at frequent intervals and the procedure stopped once anemia is corrected.
Since the mother continues to produce antibodies to Rh factor, anemia is bound to recur during the course of the pregnancy. The fetus may require multiple transfusions at intervals of 3-4 weeks if the onset of anemia is very early in pregnancy.
Fetal Transfusion needs experience and support team:
Doing Fetal Transfusion needs lot of expertise and skill. It involves cooperation of a multidisciplinary team of experts in Obstetrics, Fetal Medicine, Pathology, Neonatology and a well-equipped Blood bank. This highly specialized fetal medicine intervention was performed with the involvement of the team from Mediscan Systems, Chennai led by Dr S. Suresh and Dr S. Sudarshan.
Even after the delivery, the newborn has to be closely monitored and treated for development of jaundice and anaemia. The baby has to be under follow up care for close to 6 months due to the possibility of development of anaemia. Thereafter the baby will not need further treatment or follow up.
Conditions of the two babies:
The baby which received intrauterine blood transfusion in March 2021 has now been delivered and is healthy under follow up. The second baby which received transfusion in June 2021 is awaiting delivery.
This new treatment modality has given a chance of survival to several babies who develop anemia in-utero. A combination of medical expertise and excellent medical infrastructure is invaluable in treatment of rare and complex medical disorders. The management of PSG Hospitals and their medical team has to be commended for setting up this facility in Coimbatore for the public.
Interventional Radiology provides sigh of relief!
Interventional Radiologists make use of radiological image guidance to precisely find the cause of a block, swelling or ruptures in blood vessels and they deliver therapy using small hole (Pinhole surgery) in the groin or wrist
Two patients with different health issues have bettered their health conditions through the help of Interventional Radiology department at PSG Hospitals.
Dr.S.Elango, Interventional Radiologist at PSG shared that a woman from Coimbatore who belongs to the 50+ age group was admitted to PSG Hospitals with complaints of blood vomiting. She was stabilized and evaluated by the gastroenterology team led by Dr. Venkatakrishnan
After that a CT scan was done to look for the source of bleeding. She was found to have Gastric varices (i.e) enlarged veins in her stomach causing internal bleeding. This is a rare condition seen in patients with liver failure and if untreated can lead to severe bleeding and death.
In order to stop the internal bleeding, Interventional Radiologists Dr.Elango and Dr.Maheswaran did a minimally invasive procedure called Plug-Assisted Retrograde Transvenous Obliteration (PARTO) to treat the gastric variceal hemorrhage. The swollen blood vessels in the stomach (Varices) have completely shrunk now healed and she is back to her normal life now.
Another man who was in his 40s with similar internal bleeding issues was also handled by the Interventional radiology team recently. He was from Karur and had presented with rupture of blood vessel inside the brain (Sub-Arachnoid haemorrhage).
The patient was evaluated by Neuro team under Dr. Balakrishnan and this serious condition was found to be secondary to a swelling of blood vessel (Aneurysm) inside the brain. Normally smokers, patients with uncontrolled BP, patients with hereditary factors (family history) can get aneurysms.
Treatment for aneurysms can be done via usual surgery or through the help of interventional radiology. For this person, the procedure was done without opening the brain by a procedure called Stent Assisted Coiling.
Just like the stents which are used for blood vessels inside heart, a stent was placed in the blood vessel where it was weak. Further the swelling in the blood vessel (Aneurysm) was blocked using spring like materials called Coils. Now the weak spot (Aneurysm) which caused the bleeding has been stabilized, and the patient is back to his routine activities.
If people get unbearable headaches along with fits and vomit, it must not be ignored. It must be consulted with a physician without delaying time. A CT scan would reveal if there is anything serious to be looked after.
Both these patients arrived to the hospital in time, and immediately care was provided to them even during COVID 19 pandemic.
The highlights of Interventional radiology treatment are absence of scalpel (knife). Hence the patient’s do not have a big scar and get back to normal routine within a short period of time.