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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SC dismisses pleas seeking review of 2023 verdict declining legal sanction to same-sex marriage
New Delhi, Jan 9: The Supreme Court on Thursday dismissed a batch of pleas seeking to review its October 2023 verdict declining legal sanction to same-sex marriage.
A five-judge bench of Justices B R Gavai, Surya Kant, B V Nagarathna, P S Narasimha and Dipankar Datta took up about 13 petitions related to the matter in chambers and dismissed them.
"We do not find any error apparent on the face of the record. We further find that the view expressed in both the judgements is in accordance with law and as such, no interference is warranted. Accordingly, the review petitions are dismissed," the bench said.
It said the judges have carefully gone through the judgements delivered by Justice (since retired) S Ravindra Bhat speaking for himself and for Justice (since retired) Hima Kohli as well as the concurring opinion expressed by Justice Pamidighantam Sri Narasimha, constituting the majority view.
The bench also rejected a prayer made in the review petitions for hearing in an open court.
According to practice, the review pleas are considered in chambers by the judges.
The new bench was constituted after Justice Sanjiv Khanna, the present CJI, recused from hearing the review petitions on July 10, 2024.
Notably, Justice P S Narasimha is the only member of the original Constitution bench comprising five judges which delivered the verdict, as former CJI D Y Chandrachud and Justices S K Kaul, Ravindra Bhat and Hima Kohli have retired.
A five-judge Constitution bench led by then CJI Chandrachud on October 17, 2024, refused to accord legal backing to same-sex marriages and held there was "no unqualified right" to marriage with the exception of those recognised by law.
The apex court, however, made a strong pitch for the rights of LGBTQIA++ persons so that they didn't face discrimination in accessing goods and services available to others, safe houses known as "garima greh" in all districts for shelter to members of the community facing harassment and violence, and dedicated hotlines in case of trouble.
In its judgement, the bench held transpersons in heterosexual relationships had the freedom and entitlement to marry under the existing statutory provisions.
It said an entitlement to legal recognition of the right to union, akin to marriage or civil union, or conferring legal status to the relationship could be only done through an "enacted law".
The five-judge Constitution bench delivered four separate verdicts on a batch of 21 petitions seeking legal sanction for same-sex marriages.
All five judges were unanimous in refusing the legal recognition to same-sex marriage under the Special Marriage Act and observed it was within Parliament's ambit to change the law for validating such a union.
While former CJI Chandrachud wrote a separate 247-page verdict, Justice Kaul penned a 17-page judgement where he broadly agreed with the former's views.
Justice Bhat, who authored an 89-page judgement for himself and Justice Kohli, disagreed with certain conclusions arrived at by the former CJI, including on applicability of adoption rules for such couples.
Justice Narasimha in his 13-page verdict was in complete agreement with the reasoning and conclusion of Justice Bhat.
The judges were unanimous in holding that queerness was a natural phenomenon and not an "urban or elite" notion.
In his judgement, the former CJI recorded Solicitor General Tushar Mehta's assurance of forming a committee chaired by the cabinet secretary to define and elucidate the scope of entitlements of such couples in a union.
The LGBTQIA++ rights activists, who won a major legal battle in 2018 in the Supreme Court, which decriminalised consensual gay sex, moved the apex court seeking validation of same-sex marriages and consequential reliefs such as rights to adoption, enrolment as parents in schools, opening of bank accounts and availing succession and insurance benefits.
Some of the petitioners sought the apex court to use its plenary power besides the "prestige and moral authority" to push the society to acknowledge such a union and ensure LGBTQIA++ persons led a "dignified" life like heterosexuals.
