GMCH docs save pregnant woman and baby after severe head injury

Nagpur: Trauma Centre (TC) team of Government Medical College and Hospital (GMCH) not only saved life of a 25-year-old pregnant woman suffering severe head injury due to road accident but also saved baby in the womb. The patient, Monica Landge, was under treatment at TC for 25 days including ten days on ventilator.
Monica was hit by a speeding vehicle while standing at the roadside on March 6 evening. Thirty two-week pregnant, she received life-threatening brain injury with severe bleeding and was brought in a comatose condition. Timely intervention and team work by neurosurgeons, obstetrics and gynaecologists (OBGY) and anaesthetists ensured a good outcome.

“The challenge was to save both the mother and the baby. It required team work. The OBGY team did its job very well and regularly monitored the baby’s development and gave the required treatment. More than that, the role of anaesthetists was important as anaesthesia had to be controlled and monitored in such a way that would not harm the baby. It was a unique and rare situation for them,” Dr Pavitra Patnaik, associate professor and head of neuro-trauma, who led the neurosurgery team told TOI.

The brain was bleeding profusely at various places. There was a clot too which had to be removed. The brain tissue had swollen and required decompression. Dr Patnaik said as a part of the surgery procedure a bone under the scalp in the left portion of head was removed to avoid pressure on the brain. To keep it live, the bone has been kept under thigh muscles. It will be removed after three months and put back at its place through cranioplasty surgery. The OBGY team is trying to let the pregnancy continue to full term. But it is prepared for a premature delivery too if needed.

The patient was on ventilator in ICU for two weeks after the surgery. There was leakage from the brain. Cerebrospinal fluid was leaking from the ear which too had to be corrected. She was very normal at the time of discharge. She was breathing and eating normally on her own.

“Dr Sajal Mitra, GMCH dean, took personal interest in this case and visited the TC often. This motivated us and we were on our toes,” said Dr Patnaik.

Dr M Faisal from TC said the entire procedure and hospitalization could have cost anything between Rs10-15 lakh in private set up. Here the patient spent only Rs15,000 on certain medicines that the hospital did not have.

The neurosurgery team besides Dr Patnaik included Dr Ankur Sanghvi and resident doctors. The OBGY team included department head Dr Juzar Fidvi and Dr Anil Humne. The anaesthesia team having Dr Pradeep Dhumane and Dr Vaidya was headed by Dr Soma Cham. Other doctors involved in the treatment included Dr Meenal Gupa (ENT), Dr Sonali Kelkar, Dr Samrit Gaydhane, Dr Fahimuddin, Dr Pooja Waghmare, Dr Vivek Sangekar and Dr Sandeep Khurangan. OT sisters included Sister Bhagat and Sister Kadu.

INFORMATION

· 25-year pregnant woman met with a road accident

· She suffered severe head injury and was operated by neurosurgeons within four hours

· The OBGY team ensured the baby remained alive throughout 25-day treatment

· Anaesthesia was controlled to ensure it did not affect baby and mother remained alive