Tag: pregnancy

Dr. Pritam moon who treated her. Dr. Bipin Jibhkate ICU, Dr. Mangala patil gynac
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A Critical Covid Positive Woman Successfully Gives Birth to A Premature Baby at Wockhardt Hospital, Mira Road

Nov 12, 2020 by Gouri Achary 0 Comments #Dr Bipin Jibhkate, #Dr Mangala Patil, #Dr Pritam Moon, #Dr Samir Shaikh, #Hethal Gandhi., #pregnancy, #Premature Baby, #Wockhardt Hospital Mira Road

Pregnancy is bliss but sometimes things can go awry. A team headed by Dr Pritam Moon (consultant physician), Dr Bipin Jibhkate (Consultant and Head Critical Care Medicine), Dr Mangala Patil (Consultant Obstetrician), Dr Samir Shaikh (Consultant Neonatologist), helped a 35 years old woman beat Covid-19, and deliver a second baby at 31st week, after performing the emergency labour in ICU. The mother and baby both are doing well and have been discharged after spending 21 days at the in ICU, 14 days on the ventilator, and a total of 25 days of Hospital stay.

Pregnancy is considered one of the critical phases of a woman’s life. A woman goes through emotional, physical, and mental challenges while she carries on with her journey of becoming a mother. Hethal Gandhi, a 35 years old housewife, a resident of Mira Road, Would-be-mother with 7 months of pregnancy, was referred to Wockhardt Hospital, Mira Road, as she complained of fever of 2 days, which was followed by relatively asymptomatic phase for the patient.

Then after 5 days, the patient started feeling breathless. This was followed by desaturation. The patient was taken to a private practitioner for the above complaints. There the woman underwent a CT scan of the chest, showing 70-80% of lung involvement, as well she was tested positive for Coronavirus by RT PCR method. Since she was very breathless and was not maintaining saturation with the high flow the oxygen of 15 litres per minutes, she was shifted to Wockhardt Hospital Mira Road, for further management.

Dr Bipin Jibhkate, Consultant and Head Critical Care Medicine, Wockhardt Hospital, Mira Road said, “RT PCR test was performed on admission to confirm COVID. On admission the patient was having low Oxygen level, so was admitted to ICU and started on HFNC (high flow nasal cannula). There were multiple challenges in managing this patient in ICU as her immunity was low; her physiological needs were different from normal women. Pregnant females have a higher tendency for clotting, their abdominal pressures are high, their carbon dioxide levels are low, they have a higher tendency to vomit, and they are carrying a baby in their tummy. So in such a situation, if their oxygen level is not maintaining the options are very limited.

Considering all these things initially HFNC was tried but she could not maintain her oxygenation even with the highest settings of HFNC. So, we decided to put a tube through her mouth to her chest and put the patient on a ventilator. On ventilator initially, she was requiring very high oxygen and pressure support, even with that patient’s oxygen level was low. In such a situation, generally normal patients are managed in prone position ventilation, but due to pregnancy that was not possible with this patient, so we decided to put her in right lateral position. Along with this, she was started on standard treatment of COVID, like anti-viral, antibiotics, steroids, and anticoagulation.

She also had decreased urine, alternate hypotension and hypertension, very high heart rate of around 150/minute. Slowly she responded to the treatment and her ventilator requirement went down. But even after 7 days of ventilation, she was requiring a significant level of the ventilator and hence it was decided that we will have to remove her tube from the mouth and put it through the throat, a procedure called as a tracheostomy.

ICU team performed a procedure called a percutaneous tracheostomy. In this procedure, a hole is made in the front of the neck into the patient’s windpipe that is the trachea. We at this stage also repeated her COVID test, which turned out to be negative and patient was free from COVID. So, this patient was shifted to non-COVID ICU and slowly was taken out of ventilator after 14 days of ventilation.”

But because of all this stress of disease and ICU stay patient went into labour at 31st week of her pregnancy. The patient got premature rupture of membrane and went into labour.

Dr Mangala Patil, Consultant Obstetrician, Wockhardt Hospital Mira Road, “Considering that patient was having tracheostomy, still requiring a small amount of Oxygen, had higher chances of clot-forming which may go into lungs during operation and cause the life-threatening condition to the patient, as well anaesthesia related complication, it was decided that labour should be conducted in ICU in the supervision of Intensivists and neonatologists. This was very risky and unusual as labour is normally conducted in labour rooms.”

Ultimately labour was conducted successfully and both mother and baby were fine after that.

Dr Samir Shaikh, Consultant Neonatologist, Wockhardt Hospital, Mira Road added, “Baby weight was 1560 grams. It was a baby boy. After that baby was shifted to NICU and was treated there. Initially baby was unstable but after a few days it started improving and was ultimately discharged in stable condition.”

Dr Pritam Moon, consultant physician, Wockhardt Hospital Mira Road, said “The tracheotomy tube was closed when the patient was maintaining saturation without Oxygen support. Then the patient was shifted towards after 21 days of ICU care. Then ultimately, she was discharged in stable condition after 25 days of hospitalization. The patient is back on track and can walk without support. She can breastfeed the baby too.”

“I am elated and fortunate about the treatment I have received at Wockhardt Hospital, Mira Road. Our world came crashing down when I was tested positive for Covid. But, the doctors made sure that I deliver my baby safely, and now, my baby’s health has also improved,” concluded patient Hethal Gandhi.

Dr. Anu
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Importance of Immunization/Vaccination in Pregnancy By Dr Anu Vij, Consultant Obstetrician & Gynaecologist, Motherhood Hospital, Kharghar

Sep 2, 2020 by Gouri Achary 0 Comments #Dr Anu Vij, #Immunization/Vaccination, #Kharghar, #Motherhood Hospital, #pregnancy

Are you pregnant? Do you have a plan in place regarding your vaccination? No? Here we tell you about the important vaccines that you must not miss. Read on to know more about this…

Vaccination can be termed as a shot that contains a vaccine. Did you know? A vaccine can be called as a medicine that helps protect you from various diseases. During pregnancy, vaccinations help protect both you and your baby. Make sure your vaccinations are current before you get pregnant. Are you aware? Vaccine-preventable infectious diseases are responsible for significant maternal, neonatal, and young infant morbidity and even mortality. It is no brainer that maternal immunization can protect the mother against vaccine-preventable infections and protect the foetus.

Make sure your vaccinations are up to date before you tend to get pregnant. When you do get pregnant, consult your doctor about vaccinations that are safe to get during pregnancy. As you already know that vaccinations can help protect you from certain infections that can take a toll on you and your baby during pregnancy. Vaccinations you get during pregnancy helps keep your baby safe from infection during the first few months of life until he gets his own vaccinations. Remember not all vaccinations are safe during pregnancy. Thus, make sure any vaccination you get is safe for you and your baby.

What to do before getting vaccinated?
Before you get vaccinated, discuss with your doctor if you have any allergies or ever had a severe allergic reaction to a vaccine. An allergy is a reaction to something one touches, eat, or breathe in that makes one sneeze, itch, get a rash, or have breathing problems. Hence, your doctor will be able to determine which vaccines are safe for you.

Following vaccinations are recommended during pregnancy

• You will be advised to get a flu shot if you were not vaccinated before pregnancy.
• Tdap vaccine between 27 and 36 weeks of pregnancy. It helps protect your baby from pertussis in the first few months of life before she gets vaccinated herself. The first few months after birth are when your baby’s most at risk of getting pertussis.
• You will also be advised to get Hepatitis B Vaccine if Anti HBs antibody levels are not below 10 Miu/dl
• Omit the polio vaccine part as it is not included in the National Immunisation Program.

Which vaccines cannot be given during pregnancy?

• BCG for tuberculosis, HPV (human papillomavirus). HPV is the most common sexually transmitted infection (also called STI, sexually transmitted disease or STD).
• Include HPV in a group Vaccine immediately post-partum as this is being highly advocated.
• MMR (measles, mumps, and rubella). MMR and Varicella are not recommended during pregnancy and can be taken before pregnancy.
• Include the Rubella vaccine in a separate heading as Vaccine before contemplating pregnancy.

Takeaway: Plan your vaccinations only after consulting your doctor. This will allow you and your baby to lead a disease-free life.

pregnant women
Health

Pregnant Women’s Immune Response to a Virus May Affect Fetal Brain Cells

Aug 25, 2020 by Gouri Achary 0 Comments #and Dr. Orit Matcovitch-Natan and Amit Spinrad of the Neurobiology and Immunology Departments., #Dr. Alexander Kertser of the Neurobiology Department, #Dr. Hila Ben-Yehuda, #fetal, #immunity, #pregnancy, #virus

New Delhi, August 25, 2020: When a pregnant woman is infected with a virus, her immune system’s response to the infection may harm her baby’s brain – even if the fetus is not infected with the virus itself. This finding emerges from a study by researchers at the Weizmann Institute of Science.

It’s been long known that viral infection during pregnancy may increase the risk of schizophrenia, autism and other neurodevelopmental and neuropsychiatric disorders in her offspring later in life, but the exact mechanism of this effect is unknown. In particular, it’s been unclear whether the baby’s brain is liable to be harmed by the virus itself or by the pregnant woman’s immune response to the virus.

Prof. Michal Schwartz of Neurobiology Department and her team, in collaboration with the team of Prof. Ido Amit of the Immunology Department, explored this question in a study in mice. The researchers had seen in their previous works that within the brain, large amounts of the interferon-beta protein – which, among its other functions, serves as the first line of defence against viral infection in mammals – can harm brain cells called microglia. These cells play an important role in embryonic development, helping to shape neuronal circuits; thus, the scientists designed a study focusing on microglia in the fetus.

The infected pregnant mice with a synthetic RNA molecule that mimics an infection caused by RNA viruses. The latter belongs to a large family of viruses that induce diseases such as flu, measles, Ebola and COVID-19. When the mouse pups were born, it turned out that their brain’s immune cells, the microglia, were adversely affected and showed abnormal behaviour.

The researchers then set out to check whether this adverse effect on the microglia was caused by the virus-mimicking molecules or by the mother’s immune response to the viral infection – that is, by the antiviral immune system’s protein, interferon-beta, whose levels rise sharply as a result of this infection. They exposed the pregnant mice to the virus-mimicking molecules but at the same time treated them with antibodies that neutralize the interferon-beta. The treatment reduced the adverse effect on the microglia of the pups, suggesting that this effect was due to the interferon-beta. Next, to double-check this conclusion, the scientists – instead of infecting the pregnant mice with the virus-mimicking molecules – injected them with the interferon-beta. In this case, too, the microglia of the newborn pups displayed similar abnormal functioning. Moreover, the pups themselves were later shown to behave abnormally, in a manner similar to the one exhibited in neuropsychiatric disorders, and they were more prone to stress than those born to mothers that had not been exposed to high levels of interferon-beta.

These results show that even when the fetus is not directly exposed to a virus found in the mother’s body, the microglia in the fetal brain might be damaged by the interferon-beta that the mother secretes in large amounts in response to the viral infection. “Further research may find ways of protecting the fetus from the mother’s response to the virus – that is, from the interferon that rises during viral infection,” Schwartz says. “In the meantime, pregnant women would do well to exercise caution, so as to avoid becoming infected with viruses during pregnancy.”

The study was carried out by Dr. Hila Ben-Yehuda with the assistance of several former members of the two teams, including Dr. Alexander Kertser of the Neurobiology Department, and Dr. Orit Matcovitch-Natan and Amit Spinrad of the Neurobiology and Immunology Departments.

Prof. Ido Amit’s research is supported by the Helen and Martin Kimmel Award for Innovative Investigation; the Sagol Institute for Longevity Research; the Kekst Family Institute for Medical Genetics; the Thompson Family Foundation Alzheimer’s Research Fund; the Adelis Foundation; Richard and Jacqui Scheinberg; the Ben B. and Joyce E. Eisenberg Foundation; the Anita James Rosen Foundation; the Lowy Foundation; the Wolfson Family Charitable Trust; the Vainboim Family; Lady Michelle Michels; Rosanne Cohen; Mauricio Gerson; Erika Mogyoros; Thomas Franklin Buchheim; Jeff Pinkner and Maya Iwanaga; the estate of Simon Saretzky; and the estate of Arthur Rath. Prof. Amit is the incumbent of the Eden and Steven Romick Professorial Chair.

Prof. Michal Schwartz’s research is supported by the Sagol Institute for Longevity Research; the Thompson Family Foundation Alzheimer’s Disease Research Fund; the Adelis Foundation; the Rowland and Sylvia Schaefer Family Foundation; Carla Hunter and Andre M. Schub; and Peggy and Paul Schachter.