Udupi: Doctors at Kasturba Hospital, Manipal, safely delivered a baby girl and preserved the uterus of a 32-year-old woman whose pregnancy was complicated by serious heart disease and two exceptionally large fibroids.The woman, who was 37 weeks pregnant, had coarctation of the aorta, previously treated with a stent, a bicuspid aortic valve and long-standing hypertension. She had also lost two pregnancies to ectopic gestation and undergone surgery to remove one fallopian tube. Before the delivery, an interventional radiology team led by Dr Harshith Kramadhari placed balloon catheters in both internal iliac arteries, major vessels supplying blood to the uterus, to enable rapid control of blood flow if required.A C-section was performed under general anaesthesia by Dr Rekha, Dr Prateeksha and Dr Divya C. The baby weighed 2.6 kg.The patient developed heavy bleeding, and an initial attempt to restrict blood supply to the fibroids using Gelfoam was unsuccessful. Interventional radiologists then used medical-grade cyanoacrylate glue to seal vessels supplying the fibroids from the left uterine artery, bringing the bleeding under control. Surgeons removed both fibroids during the procedure. One measured about 15×14 cm and weighed 960 g, while the other measured around 14×12 cm and weighed 740 g.Dr Jyothi Shetty, unit chief, department of obstetrics and gynaecology, Kasturba Medical College, Manipal, said the delivery had been planned with anaesthesia and interventional radiology teams because heavy blood loss posed risks to both the uterus and heart.The woman lost about two litres of blood but did not require a massive blood transfusion. Her uterus was preserved, and she was closely monitored after surgery.
