Durban - A Durban gynaecologist and obstetrician has done the impossible and saved the life of an unborn child by drawing fluid from inside the pericardial cavity that was compressing the heart and lungs - the first time this operation has been done in South Africa.
Mother and unborn baby are healthy. The baby is due in two months.
Dr Ismail Bhorat, no stranger to revolutionary surgery, performed the pericardiocentesis at the Inkosi Albert Luthuli Central Hospital’s foetal unit on September 1. Bhorat heads the unit at the hospital.
The miracle surgery was conducted on Shakaskraal mother Thandazile Ntetha, 29, who experienced difficulties in her pregnancy at 29 weeks.
Bhorat discovered that the baby’s heart had a ventricular aneurysm (blood vessel malformation in the outer muscle of the heart) causing large amounts of fluid to accumulate. This resulted in an abnormal heart rate and rhythm.
Such a case is so rare it is seen only in 1 out of 300 000 pregnancies.
“This would have resulted in the death of the foetus. I decided to do a pericardiocentesis through ultrasound control - which is foetal cardiac surgery - to relieve the pressure on the heart,” said Bhorat.
For this, a needle was inserted under ultrasonic control through the mother’s abdomen, into the amniotic fluid, through the foetal chest wall and into the space around the heart.
This was an extremely delicate procedure and is a first for South Africa.
The doctor said 30ml of fluid was extracted.
“The procedure was a resounding success and the baby is back to normal with a healthy heart,” the delighted doctor said.
Ntetha would remain in hospital care until the birth because she had to be monitored. “This is an extremely special case which we cannot lose track of,” said Bhorat.
He performed the intricate surgery with Dr Samantha Boodhram and Dr Serantha Foolchand.
Bhorat said when his team had done extensive research, it had been established that only 22 such cases had been reported in the world and only two were similar. Such a procedure on a foetus is deemed “extremely uncommon”.
“The risk is major. We had to wait for at least 30 to 45 minutes for the baby to be in the correct position before inserting the needle. Once inserted, I had to be extra careful because the needle could not touch the heart.”
Ntetha said she was grateful to Bhorat for saving her unborn baby’s life. It will be her fourth child and it’s the first time she has had complications.
“The surgery went well and I am doing well. I am relieved that Dr Bhorat and his team were able to do what they did,” said Ntetha.
KZN Health MEC Dr Sibongiseni Dhlomo applauded the team and said the surgery was proof of the remarkable calibre of doctors working in the public health sector.
“We are elated and grateful for these doctors... the expertise displayed illustrates confidence in the public health system. We always maintain that our public hospitals have some of the best specialists in the world,” said Dhlomo.
He said it was important pregnant mothers visited antenatal clinics early.