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- ISIC exhibits optimized skill and expertise in saving the mother and child
- Patient injured severly in the spine during the accident
New Delhi, June 14, 2017 : In an exemplary case of delivering a baby safely to a woman and getting her to recover from tetraplegia (paralysis below neck due to a spinal injury) which she suffered as a result ofa road accident, the doctors at Indian Spinal Injuries Centre displayed courage, skill and expertise at the highest level. The team of doctors treating this case was led by Dr H S Chhabra, Chief of Spine Service & Medical Director, Indian Spinal Injuries Centre.
Siddhi Singla, 30 years of age and 31 weeks pregnant,suffered a near fatal motor vehicle accident while travelling to her mother’s place on the Delhi-Chandigarh highway. She was sitting in the front seat without using her seat belt. The impact of the accident resulted in a severe cervical injury at the C5 and 6 levels of her spine.
The enormity of the accident was it had the potentiality of endangering her baby’s and her life. In the circumstances of spinal injury she was immediately referred to Indian Spinal Injuries Centre, VasantKunj for further management of the debilitating injury. Doctors at Indian Spinal Injuries Centre closely monitored and took over action to stabilize her condition by putting traction for relieving pressure on cord. The main challenge however was to ensure safety of the baby in her womb which was still doing fine after the accident, say doctors.
Dr H S Chhabra, Chief of Spine Service & Medical Director, Indian Spinal Injuries Centre, says, “Spinal cord compression occurs when owing to pressure on the cord caused by bone fragments, tumors, ruptured discs, or other lesions; a patient is led to medical emergency and decreased sensation below the level of compression. When Siddhi came in to our hospital after the accident, she was suffering from severe cord compression and quadriplegia, a type of paralysis caused by injuries in general that result in partial or total loss of use of all four limbs and torso in an individual. Given the serious nature of her spine injury, immediate surgical intervention was required. However, this would have posed a threat to the baby or precipitated an early labor.With an early delivery, we would land up with all the risks of premature birth of the infant. In addition, the positioning of Siddhi on the stomach for surgery would pose a threat to the baby. Hence we planned to first reduce the dislocation in the spine by skeletal traction in which a pair of tongs drilled into the skull is used to apply increasing weights to achieve reduction aided by appropriate positioning of the head. Achieving a reduction before surgery simplified the surgery thus requiring surgery only from front with Siddhi lying on her back. Having achieved a reduction and hence removing the pressure on the spinal cord, we waited another 4 days in order to enable Siddhi reach 32 weeks of pregnancy. This ensured a much better prognosis for the child even in case of premature delivery precipitated by the spine surgery. 2 doses of Dexamethasone 12 mg injection was given to mother 12 hours apart in order to facilitate lung maturity of the child. The spine having been fixed, rehabilitation was initiated for Siddhi and she gradually started recovering from her paralysis. Both mother and child are doing well at home now.
With able guidance and assurance of a team of senior obstesticiansat ISIC led by DrRachnaVerma,Senior Gynecologist and Obstetricianintensive foetal monitoring was taken up for the patient, before and after the spine fixation surgery.
DrRachnaVerma, Senior Gynecologist and Obstetrician, ISICsays, “Traumatic life event complicates one in every 12 pregnancies, and is said to be the leading cause of fetal death related to maternal trauma. Motor vehicle accidents are among the commonest traumatic events witnessed in our country, and there are chances of fetal losses even after you have experienced minor injuries. Having said that, the biggest challenge in Siddhi’s case was to maintain a healthy pregnancy, and prevent intrauterine growth restriction, which refers to a condition where the baby is not growing at a normal rate inside the would-be mother’s womb. Periodic feotal monitoring helped ensuring that the cardiovascular rhythm of the foetus was going normal and that the baby was doing well, during and after the spine surgery.”
Every aspect of pre-natal care was monitored and finally the pregnancy reached 36 weeks. A caesarean delivery was planned in the same hospital, and everybody including the pediatric team, surgeons, anesthetists and the OT staffwere geared up to gift a healthy baby to Siddhi, who was now on the path of recovery, after the debilitating and life-threatening road traffic injury experienced only a few weeks back.
“Finally, Siddhi delivered a baby girl few days later, which is also the first baby of ISIC. The entire ISIC family is very proud of this achievement. Given the complications associated with this case, we are happy to announce now that the caesarianwent uneventful and the baby girl was born totally healthy,” adds DrRachnaVerma.
An automobile accident can happen in different ways, with impact from the front, rear, or side. Most road accidents cause extensive orthopedic or spinal injuries, along with trauma-related mental health problems.Restraints like airbags and seatbelts are often able to prevent direct contact of the upper body region during car accidents, but unfortunately in India, many people are not aware about the importance of using these precautionary tools during driving or seating inside the car.
According to the World Health Organization (WHO), road traffic injuries are the leading cause of death among young people (between the ages of 15-29) worldwide. In India, there is one death every four minutes due to a road accident, and 20 children under the age of 14 die every day due to road crashes in the country, reveals statistics released by the Ministry of Road Transport &Highways, Government of India. Injuries from road accidents can impact a person’s mobility and other functional abilities, and can turn dangerous for pregnant women in particular, suggests clinical evidence.
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