Miracle Birth

Every child born into the world is a new thought of God, an ever-fresh and radiant possibility – Kate Douglas Wiggin
On Monday November 8 Inoor Rukshana, a 32-year-old expectant mother, was admitted to the Hambantota Base Hospital for her fifth childbirth.

Rukshana was advised to undergo a planned caesarean surgery after the doctor’s examination. In normal cases, when nearing childbirth, the baby naturally turns positioning the head downwards, but since the position of Rukshana’s baby had changed several times, doctors advised her to go for a cesarean operation for the delivery of her baby.

When she was taken inside the operation theatre, the doctors started to perform the surgery as a normal caesarean procedure. However, to their utmost surprise the baby was not inside, but outside the womb.
Chief Gynecologist at the Hambantota Base Hospital, Dr Sugath B I Tissera explains that the doctors had initially planned to do a caesarean surgery because the baby’s position has changed several times and not because they identified the baby as being placed outside the womb.
This childbirth registers in history as one of the rare miracles, according to Dr Tissera who said that it was one in 10,000 cases.

Even though we have come across foetuses that have grown inside fallopian tubes, this situation is extremely rare because the baby had been inside the abdominal cavity during the time the doctors had started to perform the surgery. Rukshana, a mother who delivered four other children through normal births previously, had attended the hospital clinic only once when she was expecting the child. Afterwards, she had attended the clinic in Ambalantota while getting advice from the family health officers. None of them had identified Rukshana’s pregnancy as a rare condition because the foetus had seemed to develop normally. She had got an early ultra sound scan done but since none of the reports indicated a complication, the doctors had not directed her to seek further medical advice. However, the doctors at the Hambantota Base Hospital had acted with diligence and had delivered the baby without causing any complication to the mother or the baby.

Explaining how they carried out the surgery, Dr Tissera related that they first pulled out the leg of the baby and did not cut the whole of her placenta (water bag) to get the baby out.
“Her placenta was attached to the other tissues of her body including the tissues of her intestines and we had to be careful when performing the cutting because we had to take the baby out without injuring the mother’s internal tissues,” said Dr Tissera.

The doctors, being mindful of not causing any internal bleeding, had delivered a baby girl who is in perfect health now. The mother is also in good health, but she had been admitted to the ICU for regular examinations. “We will keep her in the ICU for two weeks though she has not shown any complication, but constant examinations will be done to ensure that she is in perfect health,” added Dr Tissera.

He also elaborated that this case is indeed a miracle because when the foetus is outside the womb, the chances of it surviving or delivering the baby without any harm coming to the mother is extremely low.
The rarity of a baby being found outside the womb is called extrauterine pregnancies where the pregnancy is implanted outside the uterine cavity. These rare pregnancies occur during the conception, as the fertilised egg travels outside the fallopian tube and plants itself in the abdominal cavity. In most extrauterine pregnancies a fertilised egg plants itself in one of the fallopian tubes.

However, when a fertilised egg is implanted in the abdominal cavity, as Dr Tissera stated, the chances of the foetus surviving is very minimal as the growth gets affected. In a normal pregnancy, the foetus is nourished while it is inside the placenta in the womb. But when the baby is conceived outside the womb the placenta is formed outside the womb and the nutrition and other outgoing fluids do not have a proper flow. This might result the foetus to be under-nourished or to have deformed lungs as contaminated fluids are inside the placenta. Also, the foetus’ growth will get affected as there is not enough room for it to exist in the abdominal cavity resulting in retardation. In most such cases early miscarriages are more likely to happen.
However, overriding all these complications, Hambantota’s miracle baby girl was delivered last Monday at around 9:30 a.m. after a 40-minute cesarean surgery. Dr Sugath Tissera, Dr Piyal Udara, Dr Nanadana Rathnasiri, Dr Amila, Anesthetist D Lekha Nilakshani and a team of nurses had performed the surgery to deliver the baby girl.

Rukshana and her husband H M Budurdeen, who is a labourer, reside in Malay Street, Ambalantota.
In Sri Lanka, this type of surgery has been done only twice and this is a miracle as Rukshana had not experienced or showed signs of any complication during pregnancy.
The lucky baby girl is to arrive at her home in two weeks and her whole family is waiting to welcome her with joy.

Courtesy - The Nation -  By Sarasi Paranamanna