Doctors help Kharghar woman with cervical insufficiency deliver baby

After three weeks of specialized care in NICU, the baby boy’s weight increased to 2 kg, and both the mother and the baby were discharged from the hospital

Navi Mumbai

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A 35 year old IT Professional from Kharghar with cervical insufficiency, recently successfully delivered a preterm baby under her challenging condition. The lady, Puneet Shaw, and her husband, a Merchant Navy officer were married for five years and were over joyed by the news of their first pregnancy but soon the joy turned into concern when she was diagnosed with cervical insufficiency at 20 weeks. Due to this condition, she had a dilated cervix of 2 cm.

“When cervical insufficiency is present, the uterus is unable to sustain a pregnancy until full term. Many second-trimester miscarriages and neonatal deaths are caused by cervical incompetence. In the second trimester, if the membranes prolapse in the vagina due to cervical incompetence it can be technically very difficult for the gynecologist to push the membranes back in the cervix and apply cerclage to prolong the pregnancy,” Dr. Shaifali Patil, Consultant Obstetrician and gynecologist, Motherhood Hospital, said. Following thorough counselling, the team of doctors performed a cervical cerclage, physically closing the open ‘cervical OS’, which is the opening in the cervix at each end of the endocervical canal.

At 20 weeks of gestation, the patient underwent cervical encirclage, a surgical procedure in which a stitch is placed around the cervix to provide support and prevent premature opening. However, at 28 weeks, it was discovered that the cervical OS (opening) was open, indicating a potential risk of preterm labor. In response to this finding, the doctor advised the patient to undergo bed rest to reduce physical activity and minimize stress on the cervix. At the 30th week patient went into labor with pain in the abdomen with a breech presentation so a combined decision of Lower segment Caesarean section (LSCS) was taken.

A team of doctors led by Dr. Patil and Dr. Suresh Birajdar, Consultant Neonatologist, and pediatrician, successfully assisted Shaw in delivering a baby boy weighing 1.5kg in the last week of October following which the child was in neonatal care. Shaw’s pregnancy was complicated due to cervical insufficiency, making it critical and high-risk. Due to the premature birth at 30 weeks and a weight of 1.5 kilograms, the baby received specialized care in the Neonatal Intensive Care Unit (NICU) for respiratory distress syndrome (RDS) and overall growth and recovery.

“Immediate decision-making is crucial in high-risk pregnancies like that of Shaw’s. Detecting and addressing complications such as cervical insufficiency early can prevent premature birth or miscarriage. Regular monitoring and follow-up are necessary to assess the effectiveness of treatment. In this case, a second cervical stitch was performed promptly when the initial cerclage did not work. Strict bed rest and close monitoring are recommended, with regular sonography to track progress and adjust the treatment plan. Emotional support and counseling with patients and their families are crucial throughout the process. Overall, immediate decision making, and skilled care can ensure a safe and successful pregnancy outcome in high-risk cases,” Dr Patil added.

Dr. Birajdar, said, “ The baby experienced prematurity condition of respiratory distress syndrome (RDS) and was given CPAP support. Throughout the baby’s recovery, we ensured that the mother practiced Kangaroo Mother Care (KMC), involving skin-to-skin contact. KMC provides essential benefits for the preterm baby, helping regulate body temperature, improve respiratory stability, boost the immune system, facilitate breastfeeding, and foster emotional bonding. After three weeks of receiving specialized care in NICU, the baby boy’s weight increased to 2 kg, and both the mother and the baby were discharged from the hospital.”

Shaw said, “The moment I held my baby for the first time was nothing short of extraordinary. I am practicing Kangaroo Mother Care as it has only deepened our bond in ways I can’t express. I am eternally thankful not just for saving lives but for giving us hope and strength throughout this journey when we were emotionally drained out.”