On 31 March, 23-year-old Shafiya from Uttar Pradesh's Bulandshahr met with a brutal motorbike accident that sent her to AIIMS Trauma Centre in Delhi. On 22 October, nearly seven months later, she gave birth to a healthy baby girl – in the very hospital, while she is still in coma from the accident.
FIT spoke to neurologist Dr Deepak Gupta, and gynaecologist Dr Anjali – whose teams treated her, to understand the rare medical event: How can someone who is unconscious give birth?
What Happened to Shafiya?
Shafiya and her husband were on their way to her maternal home, on his motorbike, when she met with an accident. The bike hit an unexpected speed-breaker, flinging the 23-year-old across the road.
The couple had been married for less than two months.
"Neither of them were wearing a helmet. She was unconscious on arrival, and had evidence of severe brain injury with acute subdural hematoma inside her brain. She was immediately put on ventilator support and taken up for emergency surgery. In this surgery, we removed the clots in her brain."Neurologist Dr Deepak Gupta to FIT
As a protocol before the surgery, she had to undergo a urine test which showed Shafiya was pregnant. According to her doctors, she was about 40 days along, at the time of her test.
Five Surgeries Over Next Five Months
While the emergency surgery was successful, she was immediately put on life support – and had to undergo a combination of five major and minor surgeries in the next five months.
Meanwhile, Shafiya was fed with the help of a pipe, and a small hole was made in her trachea – to help her breathe. This made sure that the foetus was getting the nutrition needed, and air to breathe.
"A lot of discussion was held in her first and second trimester of pregnancy on whether we should terminate her pregnancy or continue as the mother was still unconscious. As no congenital anomalies were noted in the foetus with serial level 2 ultrasound examinations, the AIIMS Medical Board constituted for this case, suggested various options to the family. The decision to terminate pregnancy in view of mother condition was left to the family. However, they would have also required to get the permission of the court."Dr Deepak Gupta
The family decided to continue her pregnancy, provided it did not harm her health.
"We had to constantly monitor the mother and the foetus as she was not in a position to assess what was happening. We were concerned whether the foetus was getting enough nutrition, or if there was normal foetal movement. We had to monitor through constant ultrasound scans."Dr Anjali Chandra, Assistant Professor, Obstetrics and Gynaecology, AIIMS told FIT
The 23-year-old spent the next two months in her husband's house in Bulandshahr.
Normal Delivery & a Healthy Baby Girl
With timely scans and blood tests, Shafiya's pregnancy passed smoothly, the doctors told FIT.
On 22 October, she was shifted once again, from Bulandshahr to AIIMS, after her water broke.
"She was in early labour when she was brought in. Medicine has advanced a lot, but we often forget that the human body knows what is needed of it. The uterus was pushing the baby out naturally. Her body was also responding to the pain, and pushing the baby out, but her uterus knew what was needed."Dr Anjali Chandra, Assistant Professor, Obstetrics and Gynaecology, AIIMS told FIT
The doctors also had to keep a close watch on the mother's vitals during the delivery, as it should not push her into a situation where she will need life support again.
"We were monitoring her vitals throughout the birth, giving all possible support so that her condition does not worsen. She gave birth to a baby girl, who weighed a healthy 2.5 kg at the time of birth. The mother is in stable condition," Dr Chandra told FIT.
However, mother is still unconscious, but is is breathing on her own, without any ventilatory support.
"She sometimes opens her eyes spontaneously, occasionally nods to painful stimuli. She stands 10-15 percent chance of regaining consciousness in next couple of years, with continued rehabilitation support," Dr Gupta told FIT.
However, Safiya is a rare case, the doctor says. "In our experience, 50 percent of people who meet with accidents, will protect themselves from severe head injury if they simply wear a helmet. It is helmet that is between life and death."
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