Dubai: In a rare, high risk pregnancy, where a 38-year old woman delivered her ninth child, which was her fifth delivery by caesarean section, doctors of Latifa and Rashid Hospitals conducted a nine-hour surgery to save the mother and the baby girl. The patient lost 25 litres of blood during the surgery which is five times the total blood in an average adult body and required transfusion of nearly 100 units of blood and blood products.
Both the mother, Sakina Jamshid Magiri, 38 and her baby Fatima are doing well a week after the surgery at the Latifa Woman and Child Hospital.
Obstetricians Dr Amal Al Qedrah and Dr Nabila Mashrawi told Gulf News: “We are a tertiary hospital and deal with very high risk cases as a matter of routine. The patient Sakina, had eight deliveries before this of which four were normal and four were by caesarean section. This was her fifth C-section delivery."
Normally, it is life threatening for any woman to have more than three child births with C-section as the wall of the uterus gets very weak. Dr Amal said: “We always counsel the patient to go in for tubal ligation (tying up of the Fallopian tubes) to avoid future pregnancies. But in this case when we called the family for counselling during her previous pregnancy, her husband and she refused to go in for the procedure. So during this pregnancy we decided to conduct the C-section in her 34th week on August 15, six weeks before full term to avoid any complications.”
However the obstetrics team, headed by Dr Mashrawi, Dr Qedrah and Dr Abeer Ammar, obstetric oncologist surgeon Dr Naqshabandi Zuhdi and anaestheologist Dr Strahil Kotsev, was in for a shock when they opened a longitudinal scar, above the placenta to deliver the baby.
“The patient had a case of placental accrete which means the placenta had invaded the scar of the previous C-section. In Sakina’s case the placenta had not only invaded her uterus and emerged but gone into her bladder and the she was bleeding profusely. We had to press the emergency blood transfusion protocol where in all the blood required is directly brought to the operation theatre, bypassing the written formalities. The patient required a blood change five times during the surgery.” said Dr Al Qedrah.
“For a moment it looked like we were losing this patient as her blood pressure dropped dangerously low, but we did not give up. A vascular team from Rashid Hospital with Dr Mamoun Shafaamri, specialist senior registrar, and Dr Saeb Bayazid, consultant surgeon, and a urological team from Dubai Hospital headed by Dr Amir and Dr Yassir were summoned and they conducted a six-hour procedure to stem the blood loss and separate the placenta from the bladder respectively,” said Dr Al Qedrah
The hysterectomy (uterus removal was conducted) and the patient also sustained an injury to her bladder but the multidisciplinary team was able to save both the mother and the baby.
Magiri is more than thrilled to be alive and full of gratitude to the team of doctors who saved her life. “I am very thankful to the doctors as they conducted this impossible feat of saving my life and that of my little baby girl, Fatima. I am feeling better and able to walk and hold my baby. Soon I will be able to go home. I thank them for this gift of life to my baby girl and me,” said Magiri.