Mangaluru: Doctors carry rare blood transfusion to baby inside mother's womb
Mangaluru: In a remarkable medical achievement, an Rh ISO immunised baby was successfully discharged after undergoing multiple blood transfusions , including rare intrauterine blood transfusion.
Dr. Ayshath Safoorah,consultant obstetrician and gynaecologist at Lifeline Health Care plus falnir, recognizing the complications of the case, referred the expectant mother to Dr. Murlidhar( fetal medicine )at Father Muller Hospital for ultrasound evaluation of foetal anemia.
After a thorough evaluation, Dr. Murlidhar carried out the intrauterine blood transfusion when the patient was in her 31st week of pregnancy.
The expectant mother, who came to Dr Ayshath Safoorah at 28th week of her pregnancy, faced complications due to antibodies present in her blood against the fetal blood cells ,along with increased blood pressure.
Three weeks following the intrauterine blood transfusion, the mother was induced at 34 weeks and delivered vaginally a preterm girl baby weighing 2.2 kg at Manglore Nursing home on 29th February .Both the mother's health and the baby's condition were closely monitored by the team of doctors at the hospital.
On Sunday, March 10, the newborn has been discharged.
What does positive Indirect Coombs Test mean?
When an Indirect Coombs Test is positive, it means that antibodies against red blood cells are present in the patient's blood serum. The test detects these antibodies indirectly by mixing the patient's serum with red blood cells of a known blood type. If antibodies in the serum react with the red blood cells, it indicates a positive result.
"In the context of pregnancy, a positive Indirect Coombs Test suggests that a pregnant woman has developed antibodies against the red blood cells of her unborn baby. This situation is often associated with Rh incompatibility, where the mother is Rh-negative, and the baby is Rh-positive.Injection Anti D is given after delivery to all Rh negative mothers to prevent this kind of iso immunisation," Dr. Ayshath Safoorah told Vartha Bharati.
What is Intrauterine blood transfusion?
Intrauterine blood transfusion is a complex medical procedure performed during pregnancy to address severe fetal anemia. Through the procedure, the baby in mother's womb is transfused blood.
Before the procedure, the mother undergoes thorough assessments, including ultrasound scans and blood tests. Continuous ultrasound guidance is used throughout the procedure to visualize the fetus, placenta, and the specific blood vessels involved. A thin, specialized needle is carefully inserted through the mother's abdomen and into the amniotic sac, guided by real-time ultrasound imaging. The goal is to reach the umbilical vein of the fetus.
Once the needle is correctly positioned, compatible blood is slowly transfused into the fetus through the umbilical vein. The amount of blood transfused is carefully controlled to avoid overloading the fetal circulation.
"Prior to the intrauterine blood transfusion,the hemoglobin of the foetus was just 4 g/dl. While this situation presented complications of cardiac failure , our medical team implemented measures to ensure a smooth transfusion ," Dr. Murlidhar who has handled cases of intrauterine blood transfusion during his practice abroad, told Vartha Bharati.
"Once the baby was delivered , she needed 2 exchange transfusions and one blood transfusion to combat the rising bilirubin levels due to hemolysis. Throughout the exchange blood transfusion, our medical team comprising Dr Preetham , faced challenges associated with the fluctuating and rising hemoglobin levels of the baby. The unexpected variations required vigilant monitoring and immediate responses to ensure the baby's stability," Dr. Abdul Bashith said while also adding that the team was overjoyed with the successful procedure and to see the baby and mother healthy.
Dr. Abdul Bashith also added that both mother and baby would require follow up at the hospital with their first visit being scheduled after 1 week .
Dr. Abdul Basith thanked and appreciated other members of the team including Manglore Nursing home NICU staffs and management, for their care and support.
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Nearly 700 km of Karnataka rivers polluted; cities, towns depend on contaminated water
Shivamogga: A total of 693.75 of river stretches across Karnataka are polluted, and water from several of these rivers is being supplied to towns and cities, the State government informed the Legislative Assembly.
According to a report published by The New Indian Express on Monday, replying to an unstarred question by Thirthahalli MLA Araga Jnanendra during the winter session in Belagavi, Forest, Environment and Biodiversity Minister Eshwar Khandre said rivers are classified into five categories, P1 to P5, based on Biochemical Oxygen Demand (BOD) levels, with P1 being the most polluted.
He reportedly said untreated domestic wastewater from urban and rural areas is the main reason for river pollution. Arkavati, Lakshana Teertha, Tungabhadra, Bhadra, Tunga, Cauvery, Kabini, Kagina, Krishna, Shimsha, Bheema and Netravati are the polluted rivers and so far, 112 polluted drainages along these rivers have been identified.
Khandre explained that rivers are classified into five pollution categories P1 to P5. The Arkavati River has been placed in the P1 category, while no rivers fall under P2 and P3. Tungabhadra, Bhadra and Shimsha are categorised under P4, and eight other rivers fall under P5.
Khandre allegedly said domestic wastewater from municipalities, towns and villages along riverbeds is being discharged into at least 17 rivers, identified by the Central Pollution Control Board (CPCB). This is the primary cause of river pollution.
According to the report, the minister said drinking water is being supplied from polluted rivers in districts such as Mandya, Ramanagara, Vijayapura and Shivamogga. In parts of Uttara Kannada, Ballari, Vijayanagara and Bagalkot, local bodies are also drawing water from polluted river sources.
In 2022-23, CPCB identified South Pinakini, Aghanashini, Sharavathi and Gangavali rivers too as polluted. But wrote to CPCB, stating that these rivers are not polluted and sought their removal from the list. An action plan is being prepared for the South Pinakini River, he said.
On remedial measures, Khandre reportedly said the Karnataka State Pollution Control Board is setting up sewage treatment plants as per the directions of National Green Tribunal.
As per the report, under 12 river rejuvenation plans, the state generates 817.31 million litres per day (MLD) of sewage. While 41 STPs with a capacity of 614.1 MLD are operational, 203.21 MLD of sewage remains untreated.
Work is underway to establish 19 STPs with a capacity of 248.91 MLD, while 39 more STPs with a combined capacity of 357.92 MLD are in the planning stage. Progress is being monitored and reported regularly to the NGT and the Union Ministry of Jal Shakti.
The minister reportedly said the state government gave its approval for underground drainage works worth Rs 535.56 crore in 2021 for 24 cities/towns besides Rs 523.80 crore for nine UGD projects.
