2 weeks Ago By Steffy Thevar
Pune: Two young women from the city underwent life-saving hysterectomies in the last week at the state-run Sassoon hospital. Both had experienced a spate of pregnancies with C-sections and multiple induced abortions. Dr Shilpa Naik, professor at the obstetrics department of BJMC and SGH, told TOI, "The first woman came to us on March 20 and the second on March 24.
In the first case, the Kondhwa resident (25) had earlier given birth to three girls via C-section and had also had three abortions. This was her seventh pregnancy, and she gave birth to a baby girl." She added, "In the second case, the Jejuri resident (29) had been through two C-sections — with one surviving girl and a neonatal death — and three consecutive induced abortions.
This was her sixth pregnancy, and she delivered a baby boy." Speaking about the first case, Naik said, "The woman came to us complaining of abdominal pain and loose motions. An MRI confirmed type 4 placenta previa with placenta increta in her 33-week gestation period.
The placenta had completely covered the cervix and grown deeply into the uterine muscles, posing significant risks of hemorrhage, forcing the C-section and hysterectomy." Naik added, "In the second case, the woman was admitted with pain in the abdomen and vaginal bleeding. Intra operative findings revealed that the placenta was adhered not only to the uterus but also the bladder.
The anterior wall of the uterus and placenta were found to be adhered to the posterior wall of the bladder." The doctor confirmed that in both cases, there was no chance of conserving the uterus. "Such patients, if left unattended, would bleed to death," she said.
Doctors said the pattern was concerning wherein two women under the age of 30 presented with placenta accreta spectrum (PAS) disorders resulting in substantial morbidity and requirement for a hysterectomy at a young age. Dr Sanjaykumar Tambe, head of the OBGYN department at BJMC and SGH, said, "In case of a normal delivery, the placenta would generally come out — in this case it was adherent and would come out in parts. This is called placental invasion, with the placenta invading outside the uterus and to nearby organs like the bladder.
With the rise of C-sections and MTP procedures, such complicated cases of placenta increta are also rising. We recommend that every pregnant woman in the seventh or ninth month undergo a sonography and doppler to check for placental invasion." As both women experienced high vaginal bleeding, doctors opted for a unique prophylactic aortic balloon placement technique to control blood flow to the pelvic region during the hysterectomy, helping them reduce blood transfusions by half of what is usually required in these cases.
Explaining the procedure, Tambe added, "With aortic balloon placement, the interventional radiologist could control the flow of blood to the pelvic region as surgeons performed a hysterectomy. The inflated balloon stops the flow of blood so that loss is minimized. But surgeons need to be quick so that other organs devoid of blood supply do not lose oxygen supply or lead to gangrene.
" Besides Dr Naik, the medical team comprised professor and head of the interventional radiology department Dr Kiran Naiknavare, senior surgeon Dr Sarfaraz Pathan, and others. BJMC and SGH dean Dr Eknath Pawar lauded the team for managing two critical cases back-to-back with a good outcome. Dr Tambe pointed out, "In Feb and March this year, we performed around 430 deliveries, of which 72 women had more than two children.
We recommend that women undergo tubectomy or some family planning method after delivery. But it is their choice." Social workers indicated that many women in the state still undergo multiple pregnancies and abortions at risk to their health.
Often, the reason is a pursuit of a male child. Elaborating on this trend, Varsha Deshpande, member of the national inspection and monitoring committee for implementing the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act, told TOI, "I have seen women undergo as many as 12 abortions in the hopes of a male child. Repeated terminations can even cause them to get cancer.
Still, many don't regret it and regard it as their duty. Many families refuse to invest in education of girls, affecting their future decisions. The aversion to having a female child is prevalent.
The sex ratio for Maharashtra is dwindling, which is very concerning." As per govt data, Maharashtra had a sex ratio of 966 females per 1,000 males as of 2021. Stay updated with the latest city news , Air Quality Index (AQI), and weather updates for major cities like Delhi , Mumbai , Noida , and Bangalore on Times of India .
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