"10 minutes. Do something or she is going to crash" : the words from our senior cardiologist were echoing in my ears.
The moment was intense. Her medical history was short. A pregnant lady in her thirties carrying live twins caught COVID at term. It was the 6th day of her illness & was having respiratory distress since 6 hours.
She was on verge of exhaustion. Perspirating & breathing at the rate of 50 breathes per minute, maintaining hardly SPo2 of 50% with full oxygen support - which was stressing her heart now. No CT or X-ray can be done as she was pregnant.
There were three lives at stake & I needed to prioritize how many we can save. A tough decision which required an ethical approval. It was 30 seconds direct communication with the most experienced critical care specialist: Intubation, Deliver the babies, shift to ICU if she survives : a clear message. The same was conveyed to the relatives.
Accepting the risk of transmission, she got intubated by chief of ER with all precautions & with the smoothe coordination between anesthesia team, Ob- Gyn team, NICU & ICU team, successful deliveries of two male babies were accomplished in no time in an isolation unit.
The babies, though suffered damage, recovered & got discharged within 7 days, but mother remained sick. High ventilatory requirement, pneumomediastinum necessitating chest tube insertion, bacterial sepsis, uterine infection, post-partum cardiomyopathy & deep venous thrombosis- she survived all.
She was decanulated after spending a month on mechanical ventilation & discharged home in stable condition with low flow oxygen on spontaneous breathes.
After witnessing the wrath of severe COVID, I believe that it was her strong motherhood factor, against which the deadliest of all illnesses surrendered, including COVID. I recollected the quote by Marion C. Garretty : "A mother’s love is the fuel that enables a normal human being to do the impossible”. Salute to the brave mother!
It was impossible to save all three lives if she would not have been shifted to Zydus Hospital, Ahmedabad. I sincerely thank Dr. Pratibha & team (Dept. Of Critical Care Medicine), Dr. Ketan Patel (Team ER), Dr. Raman Patel & team (Dept. Of Ob-Gyn), Dr. Meeta & team (Dept. of Anaesthesia), Dr. Anita & NICU team, Dr. Bhavesh Roy & team (Dept. of Cardiology) for their wonderful team work, valuable guidance & inputs.
- Dr. Jaykumar Mehta
MBBS (Gold Medalist)
MD, DNB, MNAMS, PD Fellow (Pulmonology)
Consultant Interventional Pulmonologist (Zydus Hospital, Ahmedabad)