Rapid Action
During a routine examination, doctors found that the cervix had already begun to open and the membranes were bulging. Dr Buchade immediately admitted the patient and performed an emergency cervical cerclage, a stitch placed to support the cervix. She informed the family that there are chances that pregnancy could still be at risk as the birth canal was already open. However, the stitch held, and after two weeks of rest, the patient was able to return to her daily routine.
Growth Challenge
As the pregnancy progressed, fresh complications emerged. By 25 to 26 weeks, the baby's weight began to drop and the amniotic fluid levels also started reducing. Both these conditions can be linked to placental resistance, a single umbilical artery, or constitutional factors. Dr Buchade said, "We monitored the mother using ultrasound and Doppler ultrasound scans, along with medicines and nutritional support, so that we could push the pregnancy as close to term as possible. Luckily for the mother, the baby reached 1.9 kg by 37 weeks and showed stable heart rate patterns."
Safe Delivery
Finally, the day came when an ultrasound showed that the liquor (amniotic fluid) level had dropped very low, making it necessary to plan delivery within one or two days. Steroid injections were administered for fetal lung maturity, and after 48 hours, an elective Lower Segment Caesarean Section (LSCS) was performed as the baby was in a persistent breech position and anhydramnios. The caesarean section was uneventful. The newborn cried immediately after birth, fed well, did not require Neonatal Intensive Care Unit (NICU) care, and both mother and baby were discharged together on the third day.
Doctors say this case stands out because such a combination of risks, including severe fetal growth restriction, low amniotic fluid, cervical incompetence with a short or open cervix, and a single umbilical artery, usually leads to pregnancy loss or extreme prematurity. Detecting cervical changes before symptoms appear is very uncommon, and performing an emergency cerclage at 16 weeks and also introducing medicines right on time helped in maintaining the fetal weight so that the pregnancy could be carried safely up to 37 weeks. Dr Nisha Buchade added, "Without timely diagnosis and stitching, the pregnancy might have ended before 18 weeks. However, continuous monitoring and precise decisions helped balance the mother's safety with the baby's growth."
