Dubai: In a miraculous intervention, doctors at a private hospital in Dubai enabled a critical COVID-19 patient to deliver a baby at just 24 weeks of her pregnancy, even as she battled for her life on the ventilator.
When Aiza, the 600 gram baby, was delivered through C Section at the Mediclinic Parkview Hospital in Al Barsha, her Sri Lankan mother Fathima Shafa, 24, who lay sedated and intubated, remained clueless.
While the mother managed to turn the corner within two weeks, her daughter had to stay back in the ICU for 99 days. But all’s well that ends well as the little one, who now weighs 2.45kg, was finally discharged this Monday.
For Fathima and her 33-year-old husband Mohamed Ziyan, who works with a coffee chain, the homecoming was a miracle.
When the nightmare began
“We’ve been through the worst nightmare, but are out of it now, thanks to the doctors who treated me and Aiza,” Fathima told Gulf News on Wednesday.
She said she could never have imagined she would go through such an ordeal. “My husband has been in Dubai since 2012. I joined him in December last year. Life was good and I was carrying our first child. But in June, I took ill. We had gone to the beach and when I returned, I developed high fever with chills. I could hardly breathe. We went to a private hospital where the doctor put me on antibiotics for five days. But the symptoms only got worse and when we went back to the hospital this time, I was admitted.”
Fathima said a PCR test revealed that she was COVID-19 positive. Over the next couple of days, her condition became critical and she had to be put on the ventilator. Further investigations showed she had developed severe COVID pneumonia. “At this stage, the hospital sought help to shift me to another hospital as I required advanced ventilation on an ECMO machine.”
Test for patient and doctors alike
Fathima was then transferred to Mediclinic Parkview, which is one of the only private hospitals in the UAE to have the machine. What ensued was as much a test for the young mother and her unborn child as it was for the team of doctors attending to them.
As Dr Mudit Kumar, consultant neonatologist and head of the NICU at Mediclinic Parkview Hospital, explained, “The patient, who was intubated and on the ventilator, was brought here when she was 24 weeks pregnant. The dilemma before us was whether we should prolong her pregnancy by another week so the chances of the baby’s survival would go up, or initiate an immediate C Section as any delay could cost the mother her life.”
The emergency at hand required quick decision-making based on the assessment of a multi-disciplinary team.
“An adult intensivist, an obstetrician and myself, among others, put our heads together to see what best could be done. We decided to go ahead with the baby’s delivery in the best interest of the mother. A C Section was done on the patient on the second day that she was admitted. It was very tricky given the mother’s condition and the extreme prematurity of the baby. When the baby finally arrived, she weighed only 600 grams. She was also immediately put on the ventilator.”
Baby tests negative for COVID-19
But as luck would have it, the newborn tested negative for COVID-19. Dr Kumar said: “Worldwide data shows that while only two per cent of babies become COVID-19 positive when the mother is positive, the chances of a COVID-19 positive mum delivering a premature baby goes up by 13 per cent, up from 10 per cent otherwise.”
The child, however, had breathing difficulties and remained on the ventilator for a few days. By now, Fathima did not need advanced ventilation and was extubated. A lower level of respiratory support continued, but she was ready for discharge within two weeks.
‘Anything could have happened’
The case was one of the most complicated cases that the unit had handled.
Dr Kumar said, “I have to thank the NICU, obstetric and ICU teams for their hard work and compassion in making this miracle happen.” As Dr Aisha Alzouebi, the consultant obstetrician, explained: “It was extremely challenging from a planning and technical point of view. Being in the second trimester, the uterus was not prepared for delivery. In order to save the mother’s life, delivering such a small baby needed the best anaesthetists and neonatologists.”
Gerasimos Capatos, consultant intensivist, agrees. “We knew if we followed conventional practice, the mother and baby would be in grave danger. We therefore decided as a team, the baby should be delivered immediately to save the mother. But only because we had such a dynamic neonatal unit, we could handle such a high-risk delivery. Keeping to this plan, it all worked well, thank God.”
Fathima too cannot thank God – and the doctors -- enough. “My husband went through the most trying time as our daughter and I battled for our lives. My family prayed very hard and went on a fast till the worst was behind us. Anything could have happened. I feel blessed that I was in the hands of such able doctors at the Mediclinic Parkview Hospital in Dubai.”
Hospital’s gesture ensures newborn is breastfed
The doctors went beyond their call of duty to treat the newborn as they ensured the baby was breast-fed even after the mother was discharged.
“Given the fact that the family lived far from the hospital and did not have a car, we arranged for a vehicle and driver to go their house every day to collect the mother’s express breastmilk which was fed to the baby twice a day. The benefits of breastmilk are invaluable and can immensely boost immunity of the child,” said Dr Kumar, adding that the transport arrangement also enabled the mother to visit the child frequently.
The baby remained on oxygen support for six weeks but made good progress thereafter. Dr Kumar said, “She had no morbidities and by the time she was ready for discharge on Monday - more than three months after she was born - she was very healthy, weighing 2.45kg - four times her birth weight.”
Now, that’s what you call a precious bundle of joy.