In the case of a 26-year-old pregnant woman suffering from severe cardiac complications. The importance of advanced medical interventions and a multidisciplinary approach in managing high-risk pregnancies was underscored. The patient, in her seventh month of pregnancy, was initially admitted to a hospital in Kurla with high blood pressure and vaginal bleeding. Despite being treated with medication, her condition worsened, leading to the premature birth of her baby at 28 weeks, weighing just 598 grams. Post-delivery, she experienced severe breathlessness, elevated blood pressure, and hypoxia, along with an increased respiratory rate. The initial hospital recommended transferring her to Wockhardt Hospitals for advanced care.
Upon arrival, the medical team at Wockhardt Hospitals, Mumbai Central, which includes Dr. Gandhali Deorukhkar, OBGYN, Dr Kedar Toraskar, ICU Intensivist and Dr Parin Sangoi, Cardiologist quickly secured her airway, breathing, and circulation before shifting her to the Intensive Care Unit (ICU). Comprehensive tests and scans revealed that she was suffering from Peripartum Cardiomyopathy (PPCM), a rare form of heart failure that occurs during the last month of pregnancy or up to five months postpartum. This condition leads to the weakening of the heart muscle, making it difficult for the heart to pump blood efficiently. The patient had no prior history of heart disease, which made the diagnosis even more critical.
Dr. Deorukhkar highlighted the importance of early intervention and a comprehensive care approach, stating, “This case exemplifies the need for timely and coordinated efforts in managing complex medical conditions during pregnancy. Our multidisciplinary team’s expertise and dedication were key to the patient’s recovery.”
Dr. Sangoi explained, “Peripartum Cardiomyopathy is a potentially life-threatening condition where the heart becomes enlarged and weakened, reducing its ability to pump blood effectively. Prompt diagnosis and treatment are crucial to improving outcomes.”
The patient was placed on a ventilator due to respiratory distress. Later that night, her urine output decreased significantly, a condition known as oliguria, which indicates reduced kidney function. Further tests revealed inflammation in the kidneys, prompting the medical team to initiate dialysis to support her renal function.
As her treatment progressed, there was a slow but steady improvement in her breathing rate and kidney function. Despite her heart function being critically low at 15% compared to the normal 70-80%, her creatinine levels stabilized, allowing her to be weaned off the ventilator 48 hours after delivery.
By the fourth day, another dialysis session was performed to further enhance her kidney function. Four days after the second dialysis, she was able to stand and perform simple tasks, marking a remarkable turnaround in her health. After a total of ten days in the hospital, the patient showed significant improvement.
The patient was discharged after ten days, with a stable condition and a hopeful prognosis. This case highlights the exceptional capabilities of the medical team at Wockhardt Hospitals, Mumbai Central, and their commitment to leveraging advanced medical technologies and collaborative care to save lives in challenging scenarios.
This case highlights the complex interplay between pregnancy and cardiac conditions, which can pose significant risks to both maternal and fetal health. Cardiac disease during pregnancy presents unique challenges due to physiological changes such as increased blood volume, heart rate, and cardiac output, essential for fetal development. Conditions like chronic hypertension, pulmonary hypertension, valvular heart disease, and congenital heart disease can be exacerbated by pregnancy, leading to severe complications.
New-onset conditions, such as Gestational Hypertension, Preeclampsia, Eclampsia, and PPCM, can develop during pregnancy or shortly after childbirth. Early detection and meticulous follow-up are vital for managing these conditions effectively. By addressing these risks with a comprehensive approach, including early intervention and close monitoring, healthcare providers can improve outcomes and ensure the health of both mother and baby.
Dr. Deorukhkar emphasized the importance of awareness and precautionary measures, stating, “Effective management of cardiac conditions during pregnancy requires early detection, individualized treatment, and ongoing monitoring. Our multidisciplinary team’s expertise was crucial in navigating this complex case and achieving a positive outcome.”
