A team of doctors drawn from at least five specialities — cardiology, cardiothoracic surgery, obstetrics-gynaecology, paediatrics and anaesthesia — of two government hospitals came together to perform a heart valve replacement procedure and caesarean section in a single sitting for a 23-year-old woman.
On Monday, Health Minister Ma. Subramanian appreciated the doctors of the Government Stanley Medical College Hospital and the Government RSRM Lying-in Hospital, who were involved in performing the combined caesarean delivery and aortic valve replacement procedure for the pregnant woman from Sirkazhi. The woman was diagnosed with severe aortic regurgitation with endocarditis and presented with heart failure and COVID-19 infection at 28 weeks of gestation, according to a press release.
Infective endocarditis in pregnancy was extremely rare with an incidence of one in 1,00,000 pregnancies with a high maternal and foetal mortality of up to 40%. This surgery was the first of its kind done in a government hospital in the State, the release said.
V. Rajalakshmi, superintendent in-charge, RSRM Hospital, said the patient was incidentally diagnosed with the cardiac ailment. She was admitted to the hospital and the opinion of cardiologists was obtained.
The patient was transferred to Stanley Hospital to which RSRM was affiliated considering her high-risk condition. She was under the observation of cardiologists and cardiothoracic surgeons.
“We discussed the case and thought that the baby will have a good chance to thrive if the gestation period reaches 32 weeks. The cardiologists waited for the infective endocarditis to settle. We discussed the pros and cons with them along with paediatricians and anaesthetists,” she said.
Early last month, when the patient was 32 weeks pregnant, the doctors performed a caesarean section and delivered her of the baby weighing 1.4 kg. This was followed by aortic valve replacement. The patient was under post-operative care for three weeks, and is now fit for discharge.
New facilities
The Minister inaugurated a newly installed 4,000-litre liquid medical oxygen plant and a comprehensive emergency obstetric and newborn care (CemONC) centre at RSRM Hospital.
The hospital previously had a 1,000-litre capacity plant and the new plant would cater to the oxygen requirement of the Intensive Care Unit and meet the oxygen demand for all other maternity needs.
The CEmONC centre was built at a cost of ₹12 crore. A well-baby clinic, which was renovated by EKAM Foundation with funding from HCL, was also inaugurated.
The Minister said the government had sanctioned another ₹20 crore for building six more floors for the benefit of antenatal and postpartum women in north Chennai. He instructed the officials of the Public Works Department to lay the pathway leading to the hospital.
Royapuram MLA R. Moorthy, Health Secretary J. Radhakrishnan and Stanley Hospital Dean P. Balaji were present.
