All the bags are packed and they are ready to leave. It is not only the mother who is smiling but as she cuddles her tiny newborn close, even the baby opens her eyes and a smile wreathes her lips last Tuesday.
Both mother and baby, born with a weight of only 980gms, are doing fine thanks to a ‘joint effort’ by two hospitals in the north and the south and meticulous care and treatment at the hospital in the south.
Otherwise, the story may have had a sad ending for first-time mother Kirubalini Pushpanayagam, 33, from Kandarmadam, Jaffna.
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| A picture of happiness:
Pic by Susantha Liyanawatte |
When Kirubalini, who is working at the Jaffna University branch of the People’s Bank conceived after two years of marriage, she and husband Somasundera felt their life was complete. The expectations were high but three months into the pregnancy, signs indicated that there was something amiss.
“I was feeling drowsy and sometimes had a terrible headache with much vomiting,” says Kirubalini. Her doctor, Consultant Obstetrician and Gynaecologist Dr. A. Sridharan of the Jaffna Teaching Hospital prescribed her some medication, for she had high blood pressure and also advised her to check her pressure daily.
With that her routine was set. She would go to work and then on her way home, get her pressure checked. “Sometimes my pressure was normal but at others, it was high.
Then I had to see the doctor immediately and he would tell me to rest,” she says, recalling those tensions-filled times.
February 22 was a ‘bad day’, for Kirubalini’s pressure shot up to 150/100 mmHg and when she went to see the doctor, it was immediate admission to the Jaffna Hospital.
But the upward trend continued, rising to 180/120 mmHg and by evening she was in the Intensive Care Unit.
At about 8 that night, Dr. Sridharan gently broke the news to her that she was in the ‘danger zone’ and the doctors would be compelled to perform an operation to get the baby out to save her life. Sadly, the baby wouldnot survive due to prematurity.
However, he held out a tiny sliver of hope. He had contacted Consultant Obstetrician and Gynaecologist Dr. Hemantha Perera of the Sri Jayewardenepura Hospital in Battaramulla and said there was a choice for her to try and save her baby.
Ready to ‘do anything for my baby’, the ambulance journey with a medical team and her mother brought her to Colombo from Jaffna, while her husband would make the long journey by bus.
When she arrived at Sri Jayewardenepura Hospital on February 24, Dr.Perera’s Ward 9 staff got into action promptly.
Managing the pregnancy and watching and waiting, for the baby was too small and would not have survived if born earlier, it was on March 11 when Kirubalini got a pain in the chest that a decision was taken to perform the Caesarian section under spinal anaesthesia.
“When she was brought to our ward she was only six months and three weeks (27 weeks) pregnant,” explains Dr. Perera’s Senior House Officer, Dr. S. Sivachandran.
When asked why Dr. Sridharan would have picked Sri Jayewardenepura Hospital, Dr. Sivachandran says it would have been because of the capability of Dr. Perera as well as the fact that the hospital had a good Neonatal Baby Unit.
Going into the medical issues cause by severe hypertension, Dr. Sivachandran says that it leads to pre-eclampsia and then eclampsia which is of danger to both mother and baby.
“Twenty-seven weeks are too soon to get the baby out and we kept the pregnancy going very carefully for two more weeks, medicating her intravenously with drugs which can be given during pregnancy to keep the hypertension down,” he says, explaining that invaluable support also came readily from the Medical and Nephrology Units headed by Dr. Champa Jayasundera and Dr. Chula Herath resepctively.
“It was a multidisciplinary effort,” he says, adding that the medical and nephrology input was essential as in such patients’ organs like the liver and kidneys get affected. The delivery was done as soon as Kirubalini started passing protein in her urine and went into severe pre-eclampsia.
The baby was delivered at 8 a.m. on March 11 at seven months and one week (29 weeks) and was immediately placed in the Neonatal ICU under Consultant Neonatologist Dr. Medha Weerasekera, the Sunday Times learns for she was only 980gms. Usually a full-term newborn’s weight should be more than 2.5 kilos. Premature babies also face other issues such as respiratory distress syndrome due to less lung maturity and infections.
Kirubalini was still not out of danger, for the doctors realized that there was bleeding into the abdomen and suspecting a rupture of the liver, Dr. Perera opened her up again with support from the surgical team headed by Dr. R. Piyarisi and removed the blood. Thereafter, she had to stay another six days in the ICU as she developed early features of liver failure, says Dr. Sivachandran.
The common cause of maternal deaths not only in Sri Lanka but also in the world is hypertension, and in other hospitals in the country it is managed but the survival of the baby is not guaranteed, he points out.
“I was flat,” claims Kirubalini, “and when I saw my baby after about 10 days, I was sad and crying because she was very small.”
However, with the danger period over for both mother and daughter, Anchana, they were ready to go home. With the baby now 1.28 kilos, this family from Jaffna is complete. |
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