Efforts to keep baby for mother with heart and liver damage

Ho Chi Minh City , a 37-year-old patient, who had been infertile for many years, was hospitalized due to critical multi-organ damage and only found out she was 25 weeks pregnant. Doctors made every effort to save the lives of both mother and child.

The woman had been married for more than 10 years and had been treated for infertility in many hospitals but could not get pregnant. Around April, she felt increasingly swollen in her face, limbs, and entire body, and her daily work became too much. After a month, she went to the Gia Dinh People's Hospital for emergency care because of severe difficulty breathing and had to sit up all night.

Doctors discovered that the patient was about 25 weeks pregnant, with malignant hypertension, acute pulmonary edema, and multiple organ damage including the liver, kidneys, and heart. The patient said that because she had been treated for infertility for many years without success, she did not think about the possibility of pregnancy.

Recognizing that the pregnancy was high risk for both mother and child, and that it was the couple's precious child after a long wait, the doctors consulted many specialists to find a solution, trying to save both mother and child.

Dr. Giang Minh Nhat, Head of the Cardiovascular Resuscitation Unit, said the decision to save both mother and child was a huge challenge. Cardiologists, nephrologists and obstetricians worked together to comprehensively control the risks and adverse events of pregnancy.

The team must stabilize blood pressure while ensuring continuous blood filtration for two cycles to treat kidney failure and stabilize heart muscle damage. Meanwhile, the obstetrician must continuously monitor the health of the fetus. "All of the above factors must be ensured continuously, otherwise it will lead to circulatory overload, endangering the lives of both mother and child," said Dr. Nhat.

Pregnant women are treated at the hospital. Photo: Provided by the hospital — Pregnant women are treated at the hospital. Photo: *Provided by the hospital*

After a week of intensive treatment, the patient's blood pressure was more stable. Fortunately, liver damage and myocardial damage recovered dramatically, and the fetus's health was stable. However, severe kidney damage could only partially recover. The patient was discharged from the hospital at 27 weeks of pregnancy and was monitored as an outpatient according to the high-risk pregnancy care protocol.

As the mother's condition stabilized, the baby continued to grow well in the uterus. By the 32nd week of pregnancy, the patient's blood pressure became difficult to control, resistant to all antihypertensive drugs that could be used during pregnancy, and kidney damage rapidly worsened again.

The doctor determined that the pregnancy had matured to a certain extent and the baby's chance of survival after birth was high. The experts agreed to terminate the pregnancy to better stabilize the mother's worsening medical condition. On the evening of June 22, the baby girl was born healthy.

The baby is cared for after birth. Photo: Provided by the hospital — The baby is cared for after birth. Photo: *Provided by the hospital*

Currently, the mother is receiving intensive care after giving birth and the baby is being cared for in the neonatal department. Both mother and child are expected to be discharged in the next few days.

Le Phuong

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