In a remarkable story of medical expertise, Kailash Hospital emerges as a beacon of hope for newborns and their families. The Fetal Medicine Department (FMD) of Kailash Hospital, sec 27, under the guidance of Dr Neha Gupta and Dr Pratima, provided lifesaving care – INTRA_UTERINE TRSANSFUSION (IUT)- to an unborn baby, baby of Seema Yadav. The precise diagnosis & intervention by FMD saved the life of the baby.
Patient, Mrs. Seema Yadav reached out to Kailash Hospital’s FMD around 26 weeks as she had a condition called Rh Isoimmunization and because of this condition, the unborn baby was developing anemia inside the mother’s womb. The detailed ultrasound along with the blood tests in the Department of Fetal Medicine confirmed the condition. As the critical diagnosis prompted immediate action, the couple was counselled about the life saving procedure – INTRA UTERINE TRANSFUSION (IUT). IUT is the procedure in which the blood is given to the unborn baby inside the mother’s womb. This is done by inserting a needle through the mother’s abdomen into her womb, into the unborn baby’s umbilical cord and blood is pushed through that needle into the baby.
Rh Isoimmunization is a condition that develops in mothers with Rh negative blood group, who develops antibodies against Rh antigen. Rh factor is a protein that is present on the surface of red cells in the blood. Women who do not have Rh factor have Rh negative blood group. This condition develops in those Rh negative mothers who carries Rh positive baby, which happens when their husbands are Rh positive. Usually, mother’s and unborn babies’ blood do not mix. But in situations like delivery, abortion, bleeding during pregnancy, unborn babies’ blood can enter mother’s blood. When Rh positive red cells enters blood circulation of Rh-negative mothers, the mother’s immune system recognizes Rh positive red cells as foreign like viruses and develop antibodies against them. This condition is called as Rh isoimmunization and mothers are Rh Isoimmunized.
When the first pregnancy is unaffected, these antibodies in the subsequent pregnancy cross the placenta. If the unborn baby in womb has Rh positive blood group, then, these antibodies destroys Rh positive red cells. If destruction goes beyond a limit, then the unborn baby develops anemia. If anemia is not addressed, then it leads to heart failure and eventually can die.
Timely detection & intervention are critical to avert such dire consequences. Rh isoimmunization is detected by means of a blood test called as ICT (Indirect Coombs Test). If they are ICT positive, then they need to be referred to specialized Fetal Medicine Unit for counselling, follow ups and if required to conduct intrauterine transfusion.
The incidence of Rh isoimmunization has significantly from 13% to a mere 0.3% due to administration of Rh Immunoglobulin to ICT negative Rh negative mothers, both antenatally and postnatally. Now, with the use of ANTI-D, it has led to the emergence of isoimmunization due to rare blood group antigens. This needs special expertise in diagnosis, special care and follow ups.
In the case of Mrs. Seema Yadav, Rh isoimmunization was the challenging scenario and the critical diagnosis prompted immediate action. Under the skillful guidance of Fetal Medicine Consultants, Dr. Neha Gupta and Dr. Pratima Das, Mrs. Seema Yadav underwent intra-uterine transfusion in Department of Fetal Medicine, Kailash Hospital. 3 IUTs were given to the baby inside the mother’s womb. This significant procedure made it possible to prolong the pregnancy from 26 weeks to 34 weeks. Delivery was done at 34 weeks. After delivery, the baby received exchange transfusion and IVIg in the Neonatal Intensive Care Unit (NICU) under the care of Dr. Ankit Soni, Neonatologist at Kailash Hospital, Sec-71 Noida. The baby was discharged on day 5 of the life in a healthy condition.
Kailash Hospital takes pride in its commitment to provide exceptional medical care and expertise, particularly in complex cases like Rh isoimmunization. The successful outcome of Mrs. Seema Yadav’s case is a testament to the hospital’s unwavering dedication to the patient well-being and its ability to navigate the challenging medical conditions.